***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: AIM This paper is a report of a study to explore the effects of psychosocial group nursing intervention on older people 's feelings of loneliness , social activity and psychological well-being . BACKGROUND Older people 's loneliness is associated with low quality of life , and impaired health , increased use of health and social services and increased mortality . Previous intervention studies have achieved quite modest results . METHOD A r and omized controlled trial was conducted between 2003 and 2006 using a group intervention aim ed at empowering older people , and promoting peer support and social integration .  A total of 235 people ( > 74 years ) suffering from loneliness met 12 times with professional leaders in groups . The UCLA Loneliness Scale and Lubben 's Social Network Scale were used at entry , after 3 and 6 months . Psychological well-being was charted using a six-dimensional question naire at baseline and 12 months later . FINDINGS A statistically significantly larger proportion of intervention group participants had found new friends during the follow-up year ( 45 % vs. 32 % , P = 0.048 ) , and 40 % of intervention group participants continued their group meetings for 1 year . However , no differences were found in loneliness or social networks between the groups . Psychological well-being score improved statistically significantly in the intervention groups [ + 0.11 , 95 % confidence interval ( CI ) : + 0.04 to + 0.13 ] , compared with the controls ( + 0.01 , 95 % CI : -0.05 to + 0.07 , P = 0.045 ) . Feeling needed was statistically significantly more common in the intervention groups ( 66 % ) than in controls ( 49 % , P = 0.019 ) . CONCLUSION New sensitive measurements of loneliness and social isolation are needed to measure fluctuations in feelings of loneliness and in social isolation Background Social isolation affects a significant proportion of older people and is associated with poor health outcomes . The current evidence base regarding the effectiveness of interventions targeting social isolation is poor , and the potential utility of mentoring for this purpose has not previously been rigorously evaluated . The purpose of this study was to examine the effectiveness of a community-based mentoring service for improving mental health , social engagement and physical health for socially isolated older people . Methods This prospect i ve controlled trial compared a sample of  mentoring service clients ( intervention group )  with a matched control group  recruited through general practice . One hundred and ninety five participants from each group were matched on mental wellbeing and social activity scores . Assessment s were conducted at baseline and at six month follow-up . The primary outcome was the Short Form Health Survey v2 ( SF-12 ) mental health component score ( MCS ) . Secondary outcomes included the SF-12 physical health component score ( PCS ) , EuroQol EQ-5D , Geriatric Depression Score ( GDS-10 ) , social activity , social support and morbidities . Results We found no evidence that mentoring was beneficial across a wide range of participant outcomes measuring health status , social activity and depression . No statistically significant between-group differences were observed at follow-up in the primary outcome ( p = 0.48 ) and in most secondary outcomes . Identifying suitable matched pairs of intervention and control group participants proved challenging . Conclusions The results of this trial provide no substantial evidence supporting the use of community mentoring as an effective means of alleviating social isolation in older people . Further evidence is needed on the effectiveness of community-based interventions targeting social isolation . When using non-r and omised design s , there are considerable challenges in the recruitment of suitable matches from a community sample .Trial registration SCIE Research Register for Social Care Background We investigated the effectiveness of an occupational therapy led self-management support programme , OPTIMAL , design ed to address the challenges of living with multiple chronic conditions or multimorbidity in a primary care setting . Methods Pragmatic feasibility r and omised controlled trial including fifty participants with multimorbidity recruited from family practice and primary care setting s.  OPTIMAL is a six-week community-based programme , led by occupational therapy facilitators and focuses on problems associated with managing multimorbidity . The primary outcome was frequency of activity participation . Secondary outcomes included self-perception of , satisfaction with and ability to perform daily activities , independence in activities of daily living , anxiety and depression , self-efficacy , health-related quality of life , self-management support , healthcare utilisation and individualised goal attainment . Outcomes were collected within two weeks of intervention completion . Results There was a significant improvement in frequency of activity participation , measured using the Frenchay Activities Index , for the intervention group compared to the control group ( Adjusted Mean Difference at follow up 4.22 . 95 % Confidence Interval 1.59 - 6.85 ) . There were also significant improvements in perceptions of activity performance and satisfaction , self-efficacy , independence in daily activities and quality of life . Additionally , the intervention group demonstrated significantly higher levels of goal achievement , following the intervention . No significant differences were found between the two groups in anxiety , depression , self-management scores or healthcare utilisation . Conclusions OPTIMAL significantly improved frequency of activity participation , self-efficacy and quality of life for patients with multimorbidity . Further work is required to test the sustainability of these effects over time but this study indicates that it is a promising intervention that can be delivered in primary care and community setting s . Trial registration Trial Number : IS RCT Objectives : The objectives of this study were to examine whether a leisure education program could facilitate leisure competence among older adults and whether it could also reduce their stress . Methods : A pre-test – post-test r and omized experimental design was conducted . Subjects were r and omly assigned to either an experimental group  ( n = 30 ) or a control group ( n = 30 ) . A leisure education program was used to serve as the intervention . A day before this experiment was carried out , pre-test data were collected using leisure competence and stress scales . Thirty minutes after this experiment ended , post-test data were collected using the same scales . These data were analyzed using an analysis of covariance . Results : The results indicated that the average post-test scores of leisure competence in the experimental group were significantly higher than those in the control group and that the average post-test scores of stress in the experimental group were significantly lower than those in the control group . Conclusion : Healthcare practitioners should adopt the provision of leisure education as a priority to facilitate leisure competence and reduce stress among older adults BACKGROUND Social isolation is associated with poorer health , and is seen by the World Health Organisation ( WHO ) as one of the major issues facing the industrialised world . AIM To explore the significance of social isolation in the older population for GPs and for service commissioners . DESIGN OF STUDY Secondary analysis of baseline data from a r and omised controlled trial of health risk appraisal . SETTING A total of 2641 community-dwelling , non-disabled people aged 65 years and over in suburban London . METHOD Demographic details , social network and risk for social isolation based on the 6-item Lubben Social Network Scale  , measures of depressed mood , memory problems , numbers of chronic conditions , medication use , functional ability , self-reported use of medical services . RESULTS More than 15 % of the older age group were at risk of social isolation , and this risk increased with advancing age . In bivariate analyses risk of social isolation was associated with older age , education up to 16 years only , depressed mood and impaired memory , perceived fair or poor health , perceived difficulty with both basic and instrumental activities of daily living , diminishing functional ability , and fear of falling . Despite poorer health status , those at risk of social isolation did not appear to make greater use of medical services , nor were they at greater risk of hospital admission . Half of those who scored as at risk of social isolation lived with others . Multivariate analysis showed significant independent associations between risk of social isolation and depressed mood and living alone , and weak associations with male sex , impaired memory and perceived poor health . CONCLUSION The risk of social isolation is elevated in older men , older persons who live alone , persons with mood or cognitive problems , but is not associated with greater use of services . These findings would not support population screening for individuals at risk of social isolation with a view to averting service use by timely intervention . Awareness of social isolation should trigger further assessment , and consideration of interventions to alleviate social isolation , treat depression or ameliorate cognitive impairment BACKGROUND In the UK , population screening for unmet need has failed to improve the health of older people .  Attention is turning to interventions targeted at ' at-risk ' groups . Living alone in later life is seen as a potential health risk , and older people living alone are thought to be an at-risk group worthy of further intervention . AIM To explore the clinical significance of living alone and the epidemiology of lone status as an at-risk category , by investigating associations between lone status and health behaviours , health status , and service use , in non-disabled older people . DESIGN OF STUDY Secondary analysis of baseline data from a r and omised controlled trial of health risk appraisal in older people . SETTING Four group practice s in suburban London . METHOD Sixty per cent of 2641 community-dwelling non-disabled people aged 65 years and over registered at a practice agreed to participate in the study ; 84 % of these returned completed question naires . A third of this group , ( n = 860 , 33.1 % ) lived  alone and two-thirds ( n = 1741 , 66.9 % ) lived with someone else . RESULTS Those living alone were more likely to report fair or poor health , poor vision , difficulties in instrumental and basic activities of daily living , worse memory and mood , lower physical activity , poorer diet , worsening function , risk of social isolation , hazardous alcohol use , having no emergency carer , and multiple falls in the previous 12 months . After adjustment for age , sex , income , and educational attainment , living alone remained associated with multiple falls , functional impairment , poor diet , smoking status , risk of social isolation , and three self-reported chronic conditions : arthritis and /or rheumatism , glaucoma , and cataracts . CONCLUSION Clinicians working with independently-living older people living alone should anticipate higher levels of disease and disability in these patients , and higher health and social risks , much of which will be due to older age , lower educational status , and female sex . Living alone itself appears to be associated with higher risks of falling , and constellations of pathologies , including visual loss and joint disorders .  Targeted population screening using lone status may be useful in identifying older individuals at high risk of falling Abstract Objective : The aim of this exploratory r and omised controlled trial ( RCT ) was to evaluate three different occupation-focused interventions for well older people by estimating effect sizes for leisure engagement and ability in activities of daily living ( ADL ) and thereby identifying the most effective interventions . Methods : One hundred and seventy seven persons , 77–82 years old , living alone and without home help , were r and omized to a control group ( CG ) , an individual intervention ( IG ) , an activity group ( AG ) , and a one-meeting discussion group ( DG ) . All interventions focused on occupational engagement and how persons can cope with age-related activity restrictions in order to enhance occupational engagement . Data were collected by blinded research assistants at baseline , three , and 12 months . Ordinal outcome data were converted , using Rasch measurement methods , to linear measures of leisure engagement and ADL ability . St and ardized between-group effect sizes , Cohen ’s d , were calculated . Results : While all groups showed a decline in leisure engagement and ADL over time , the IG and the DG were somewhat effective in minimizing the decline at both three and 12 months . However , the effect sizes were small . Conclusions : The findings indicate that occupation-focused interventions intended to minimize a decline in leisure engagement and ADL were sufficiently promising to warrant their further research 
    Output:
    
Mixed evidence exists for community‐based group interventions and electronic gaming to support social participation .
NA ; ILeisure education and chronic disease self‐management programs were found to support leisure engagement among community‐dwelling older adults , whereas the evidence for group interventions and electronic gaming for social participation outcomes was mixed