Background: Newly graduated nurses' communication ability often does not satisfy the needs of clinical sites. New training pedagogies are needed to help nursing students improve communication skills. This study aimed to evaluate the effects of simulation-based deliberate practice on cultivating nursing students' communication, empathy, and self-efficacy. Method: The study was a randomized controlled trial. A total of 132 first-year nursing students participated in the study at a nursing school in China. The intervention was guided by simulation-based education and deliberate practice. The Clinical Communication Ability Scale, Jefferson Scale of Empathy-Health Professionals, and General Self-Efficacy Scale were used to measure the students' outcomes. Results: After the intervention, students' scores of clinical communication ability, empathy, and self-efficacy in the experimental group all increased significantly, compared with those of the control group. Conclusion: The simulation-based deliberate practice program is a feasible teaching method targeting improvement in nursing students' communication, empathy, and self-efficacy. [ J Nurs Educ . 2019;58(12):681–689.]

In ischemia-reperfusion stroke, microglia play a dual role in brain injury as well as brain repair, and promoting their switch from a pro-inflammatory M1 phenotype to an anti-inflammatory M2 phenotype is considered to be a potential therapeutic strategy. Docosahexaenoic acid (DHA) is an essential long-chain omega-3 polyunsaturated fatty acid that exhibits potent anti-inflammatory properties in the acute phase of ischemic stroke, but its effect on microglia polarization is unknown. Thus, the objective of this study was to investigate the neuroprotective effects of DHA on rat brain following ischemia-reperfusion injury, and to investigate the mechanism by which DHA regulates microglia polarization. We administered DHA 5 mg/kg intraperitoneally daily for 3 d following a transient middle cerebral artery occlusion reperfusion model in rats. The protective effects of DHA on cerebral ischemia-reperfusion injury were detected by TTC staining, HE staining, Nissler staining, and TUNEL staining. Quantitative real-time PCR, immunofluorescence, western blot, and enzyme-linked immunosorbent assay were used to detect the expression of M1 and M2 microglia-associated markers and PPARγ-mediated ERK/AKT signaling pathway proteins. We found that DHA significantly improved brain injury by decreasing the expression of the M1 phenotypic marker (iNOS, CD16) and increasing the expression of the M2 phenotypic marker (Arg-1, CD206). DHA also increased the expression of peroxisome proliferator-activated receptor gamma (PPARγ) mRNA and protein, increased the expression of the pathway protein AKT, and decreased the expression of ERK1/2. In addition, DHA promoted the expression of anti-inflammatory factor IL-10 and decreased the expression of pro-inflammatory factors TNF-α and IL-1β. However, the PPARγ antagonist GW9662 greatly blocked these beneficial effects. These results suggest that DHA may activate PPARγ to inhibit ERK and activate AKT signaling pathways to regulate microglia polarization, thereby reducing neuroinflammation and promoting neurological recovery to alleviate cerebral ischemia-reperfusion injury.

Background: Although Alzheimer’s disease (AD) mainly affects cognitive function, it is often accompanied by sleep disorders and psychobehavioral symptoms. These symptoms, including depression, agitation, and psychotic symptoms, are prominent hospitalization causes among patients with AD. Currently, relatively more research exists on light therapy for sleep disorders, while those on psychobehavioral symptoms are gradually increasing. However, no consensus exists on these results because of the vulnerability of light therapy to multiple factors, including light intensity and duration. Thus, further research investigating this aspect is warranted. Objective: To evaluate the efficacy of light therapy in improving sleep disorders and psychobehavioural symptoms in patients with AD. Methods: In this meta-analysis, relevant literature was searched in Embase, the Clinical Trials Registry, Web of Science, PubMed, and the Cochrane Library up to December 2022. Furthermore, a fixed-effects model was used for data analysis. Results: Fifteen randomized controlled trials involving 598 patients with AD were included. In the case of sleep disorders, our meta-analysis revealed that light therapy significantly improved sleep efficiency (MD = −2.42, 95% CI = −3.37 to −1.48, p < 0.00001), increased interdaily stability (MD = −0.04, 95% CI = −0.05 to −0.03, p < 0.00001), and reduced intradaily variability (MD = −0.07, 95% CI = −0.10 to −0.05, p < 0.00001). With respect to psychotic behavior, light therapy was found to alleviate depression (MD = −2.55, 95% CI = −2.98 to −2.12, p < 0.00001) as well as reduce agitation (MD = −3.97, 95% CI = −5.09 to −2.84, p < 0.00001) and caregiver burden (MD = −3.57, 95% CI = −5.28 to −1.87, p < 0.00001). Conclusion: Light therapy leads to significant improvement in sleep and psychobehavioral symptoms and is associated with relatively fewer side effects in patients with AD, indicating its potential as a promising treatment option for AD.