Do caregiver interventions improve outcomes in relatives with dementia and mild cognitive impairment? A comprehensive systematic review and meta-analysis.

Some reviews suggest benefits of nonpharmacological interventions for informal caregivers of people with dementia and mild cognitive impairment. These benefits may transfer to the care-recipients (CRs) through increased caregiving capability, reduced burden and depression among caregivers, and decreased negative mood contagion. However, large-scale review on these effects on the CRs is lacking. We searched PsycINFO, CINAHL with Full Text, MEDLINE, and PubMed from inception to end of 2020 and found 142 articles that reported randomized controlled trials (RCTs) of caregiver interventions using CR outcomes. Interventions were found to reduce neuropsychiatric symptoms (NPS) in general and behavioral and mood disturbance specifically, enhance cognition and quality of life, and delay institutionalization and mortality, with care coordination/case management, educational intervention with psychotherapeutic components (psychoeducation-b), and direct training of the CR (with caregiver involvement) being the more potent interventions. The kinds of benefit depend on the types of intervention. NPS was reduced by psychoeducation-b, care coordination/case management, and CR training. Cognition and quality of life were enhanced by CR training and care coordination/case management, respectively. Institutionalization was delayed by multicomponent interventions and respite (based on one study). However, the effects were generally small to very small. Together with existing findings on caregiver outcomes, a tripartite scaffolding model of caregiver support is proposed. The model is composed of three components: (a) care coordination/case management (i.e., enhanced usual care), (b) psychoeducation-b, and (c) CR training. Future directions in terms of developing consensual guidelines, a registry of intervention manuals, and family-centered programs with flexibility in delivery are discussed. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

How different health literacy dimensions influences health and well-being among men and women: The mediating role of health behaviours.

BACKGROUND: Health literacy, the ability to access, understand, evaluate and apply health information, was found to contribute to positive health outcomes, possibly via promoting healthy behaviours. However, the specific pathways linking different health literacy skills to health and well-being have remained unclear. METHODS: A cross-sectional survey with structural questionnaires was administered among 2236 adults in Hong Kong (mean age = 46.10 ± 19.05). Health literacy was measured by HLS-Asian-47. Participants' physical conditions and subjective well-being were predicted by health literacy and health behaviours with structural modelling path analysis. RESULTS: Health literacy in finding and understanding information showed a direct effect on enhancing physical health, while applying information capacity had an indirect positive effect via promoting health behaviours, which was moderated by sex. Only among women, this indirect effect predicting fewer physical symptoms and better well-being was significant. CONCLUSIONS: Different health literacy dimensions showed distinct direct and indirect pathways in influencing health for men and women. Based on the findings, skill trainings should be developed to enhance both gender's abilities of finding and understanding health information, while the ability of applying health information should also be improved for modifying lifestyle and promoting health, particularly for women. PATIENT OR PUBLIC CONTRIBUTION: Two thousand and two hundred thirty-six adults from different districts of Hong Kong participated in the study, and responded to questions on health literacy, behaviours and health status.

A program to improve the hand hygiene compliance of Hong Kong preschoolers with an insight into their absenteeism.

BACKGROUND: Hand hygiene prevents cross-infection and is the most effective defense against contagious diseases. Preschoolers, without proper hand hygiene skills, are a vulnerable group to such diseases. The aim of this study was to evaluate whether hand hygiene compliance training of preschoolers in Hong Kong improves their hand hygiene knowledge and performance, and whether the training reduces their absenteeism resulting from influenza symptoms. METHODS: This was a quasi-experimental study with a pretest-posttest design. A total of 110 preschoolers participated in a program consisting of 4 training sessions on hand hygiene. Before and after the program, their hand hygiene knowledge was assessed by 10 true or false questions, and their handwashing skills were assessed by photos of their hands taken before and after handwashing. Before handwashing, a fluorescent stain gel was used to cover their hands. To determine whether a causal relationship existed between compliance and absenteeism, the preschoolers' absenteeism data were collected during a period of 3 months for analysis. RESULTS: Significant differences were found in hand hygiene knowledge on handwashing steps, duration, and after playing with toys. Percentage increases were recorded for 8 questions. There was significant improvement in hand hygiene performance on the fronts and the backs of fingers, thumbs, and fingertips (P < .05). The findings showed a decrease in absence rates with influenza symptoms for the month before (31%), during (30%), and after (25%) the completion of the program in all participating schools. DISCUSSION: After the training program, the participants' hand hygiene knowledge and performance considerably improved. They washed their hands more thoroughly and there was a significant reduction in absences owing to influenza. CONCLUSIONS: Good cooperation between schools and families is found to be important in helping students build positive attitudes and habits, even in performing simple routines like hand hygiene.

Effect of Kinesio taping on Y-balance test performance and the associated leg muscle activation patterns in children with developmental coordination disorder: A randomized controlled trial.

BACKGROUND: Children with developmental coordination disorder (DCD) have leg muscular deficits which negatively affects their dynamic postural stability. Kinesio tape (KT) could enhance muscle activation, postural control and functional activities in healthy individuals. Therefore, we hypothesized that the usage of KT may address the postural instability problem of children with DCD. RESEARCH QUESTION: To investigate the immediate effect of KT on dynamic postural stability and the associated lower limb muscle activity in children with DCD. METHODS: Forty-nine children with DCD were recruited where twenty-five children were randomly assigned to the KT group (mean age = 8.18 ± 1.16 years) and twenty-four to the control group (mean age = 8.06 ± 0.93 years). KT group received KT application to the rectus femoris and gastrocnemius muscles whereas the control group received no intervention. Measurements were taken before and after the application of KT. Dynamic balance performance was measured using a lower quartile Y-balance test (YBT-LQ). Leg muscle peak activation and time-to-peak muscle activation of the dominant lower limb during YBT-LQ were measured by surface electromyography. RESULTS: YBT-LQ composite score increased by 6.3% in the KT group at posttest (95% CI: -7.308, -2.480). In addition, a higher rectus femoris peak activation was illustrated for YBT-LQ anterior (32.5%; 95% CI: -48.619, -16.395) and posteromedial (24.6%; 95% CI: -42.631, -6.591) reach directions from pretest values in the KT group. Moreover, KT group exhibited a 38% (95% CI: 0.015, 2.983) longer gastrocnemius medialis time-to-peak duration for YBT-LQ posteromedial reach direction when compared to the control group. SIGNIFICANCE: KT revealed an immediate beneficial effect on YBT-LQ performance. Application of KT also increased rectus femoris peak activation and lengthened the muscle time-to-peak duration for specific reach directions. Incorporating KT as an adjunct with dynamic balance training programme could be beneficial for children with DCD.

Comparison of hand contamination rates and environmental contamination levels between two different glove removal methods and distances.

BACKGROUND: Gloves are a necessary contact precaution to prevent transmission of infectious pathogens that spread by direct or indirect contact with an infected person or a contaminated environment. This article reports a study investigating hand and environmental contamination levels when health care workers (HCWs) followed two different methods of removing gloves at two distances from the rubbish bin. METHODS: Fifty HCWs performed a personal or causal glove removal method (pretest) and a Centers for Disease Control (CDC)-recommended glove removal method (posttest) at distances of 2 feet and 3 feet from the rubbish bin after the application of fluorescent solution (the simulated contaminant) onto their gloved hands. RESULTS: The incidence of the small patch of fluorescent stain (<1 cm(2)) on the front of the doffed gloves was significantly lower in the posttest than in the pretest. The incidence of small and large patches (>1 cm(2)) on the front of the doffed gloves and on the cover of the rubbish bin was significantly lower at 3 feet than at 2 feet. Health care assistants had significantly higher levels of contamination than other HCWs in the pretest but not in the posttest. There was no significant difference in hand contamination rate between pretest and posttest based on distance from the rubbish bin and type of HCW. CONCLUSION: The impact of the glove removal procedure and the distance to the bin in which used gloves are discarded should be taken into consideration on a daily basis, along with the supervision of infection control measures by minor staff.