***TASK***
the task is to simplify the input abstract of a biomedical literature

***INPUT***
the input is the abstract of a biomedical literature

***OUTPUT***
the output is the simplified abstract for the input abstract of a biomedical literature

***DOCUMENTATION***

***EXAMPLES***

Input: No RCTs meeting the selection criteria were identified. Since it is unlikely, for ethical and practical reasons that an RCT of SCUs will be conducted, a systematic review of non-RCTs using the same protocol and criteria was conducted. There were eight non-RCTs that fulfilled the criteria for inclusion. Only four studies had data which could be extracted for pooling in meta-analysis.  Differences between comparator groups in these nonRCTs ? for example in severity of dementia - were not adequately adjusted for and were common in the trial which accounted for almost all of the positive outcomes of SCUs (Nobili, 2006) All of the results of the outcomes came only from single studies except for "physical restraint use" at 6 months, which included data from two studies.  A small improvement in total Neuropsychiatric Inventory scores, favouring SCU was noted in one study at 6, 12 and 18 months.  The use of physical restraints was less common in SCUs at 6 and 12 months (OR= 0.46 (95% CI 0.27 to 0.80), p=0.006; and OR=0.49 (0.27 to 0.88), p=0.02 respectively).  Patients in SCUs were less depressed at 3 months than those in traditional nursing home (WMD -6.30 (-7.88 to -4.72) Cornell points, p<0.00001). There was only one observation that favoured the control group: a small but significant effect favouring traditional nursing home care was observed at 6 months in the mean number of psychotropic medications used (WMD 0.20, CI 0.00 to 0.40, z=1.96, P=0.05). There are no identified RCTs investigating the effects of SCUs on behavioural symptoms in dementia, and  no strong evidence of benefit from the available non-RCTs.  It is probably more important to implement best practice than to provide a specialized care environment.  The routine collection of data on behaviour, restraint and psychotropic drug use across multiple nursing home settings offers the best modality for formal evaluation of the benefit or otherwise of SCUs.
Output:

No randomized controlled trials (RCTs) can be found comparing the effect of SCUs against traditional nursing units in managing agitated behaviours in people suffering from dementia. This review has examined the results of non-RCTs. The findings about the outcomes of this review arise just from one study except for the outcome of "physical restraint use" at 6 months, which includes data from two studies. Selection bias is a major problem in non-RCTs, and confounds the limited evidence that favoured SCU care with regard to a decrease in agitated behaviour and in the use of physical restraints. A convincing case for the benefits of SCU care cannot be made and further studies are necessary.