Introduction: Nonpharmacological therapies (NPTs) can improve the quality of life (QoL) of people with Alzheimer’s disease (AD) and their carers. The objective of this study was to evaluate the best evidence on the effects of NPTs in AD and related disorders (ADRD) by performing a systematic review and meta-analysis of the entire field. Methods: Existing reviews and major electronic databases were searched for randomized controlled trials (RCTs). The deadline for study inclusion was September 15, 2008. Intervention categories and outcome domains were predefined by consensus. Two researchers working together detected 1,313 candidate studies of which 179 RCTs belonging to 26 intervention categories were selected. Cognitive deterioration had to be documented in all participants, and degenerative etiology (indicating dementia) had to be present or presumed in at least 80% of the subjects. Evidence tables, meta-analysis and summaries of results were elaborated by the first author and reviewed by author subgroups. Methods for rating level of evidence and grading practice recommendations were adapted from the Oxford Center for Evidence-Based Medicine. Results: Grade A treatment recommendation was achieved for institutionalization delay (multicomponent interventions for the caregiver, CG). Grade B recommendation was reached for the person with dementia (PWD) for: improvement in cognition (cognitive training, cognitive stimulation, multicomponent interventions for the PWD); activities of daily living (ADL) (ADL training, multicomponent interventions for the PWD); behavior (cognitive stimulation, multicomponent interventions for the PWD, behavioral interventions, professional CG training); mood (multicomponent interventions for the PWD); QoL (multicomponent interventions for PWD and CG) and restraint prevention (professional CG training); for the CG, grade B was also reached for: CG mood (CG education, CG support, multicomponent interventions for the CG); CG psychological well-being (cognitive stimulation, multicomponent interventions for the CG); CG QoL (multicomponent interventions for PWD and CG). Conclusion: NPTs emerge as a useful, versatile and potentially cost-effective approach to improve outcomes and QoL in ADRD for both the PWD and CG.

Title. Disaster preparedness among Hong Kong nurses. Aim. This paper is a report of a survey to explore Hong Kong nurses' disaster preparedness. Background. Increasingly frequent global disasters are posing threats to human health and life. The World Health Organization has called for countries to have detailed plans at all levels in order to be prepared for disasters that may arise. Method. A questionnaire was distributed to convenience samples of practising Registered Nurses studying in Master's degree programmes at a Hong Kong university in 2007. Results. Of a possible 174, 164 questionnaires were returned (Response rate 94%). Almost all nurses (97AE6%) considered the government health department to be the organization most involved in disastrous situations. The majority (84AE8%) were aware of the existence of a protocol on disaster management at their workplace. About one-third would respond in accordance with protocol (38AE4%) or rely on directions from their immediate supervisors (34AE8%) if a disaster occurred. Almost all the nurses (97%) considered themselves not adequately prepared for disasters. They recognized that a protocol for disaster management (85AE4%) and training and drills for disasters (both 84AE1%) are useful tools. Conclusion. Nurses in Hong Kong are not adequately prepared for disasters, but are aware of the need for such preparation. Disaster management training should be included in the basic education of nurses.

These data could serve as a basis for re-educating nursing staff on the subject. Staff with more clinical experience could give appropriate guidance to other members of staff on decisions to apply restraints. More effective alternative interventions to restraining clients should be explored. Once the gaps in knowledge are closed, more positive attitudes among staff towards the use of restraints can be cultivated, thus leading to a higher standard of nursing practice.

Knowledge generated through research remains insufficient to explain fully why and when wandering occurs. Variability in how the phenomenon was defined and studied, and the small size of the samples made generalizability of findings difficult. Future research should incorporate a clearer definition of wandering; a specific targeted population with representative sample size; appropriate subject identification strategies; focussed interventions, and better control conditions.

Background: To date, no firm conclusions can be reached regarding the effectiveness of reminiscence for dementia. Researchers have emphasized that there is an urgent need for more systematic research in the area.