***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: Primiparous women ( n = 627 ) were screened on state and trait anxiety measures in the post-partum period ; sub-groups of highly anxious ( n = 89 ) , moderately anxious ( n = 29 ) , and minimally anxious ( n = 29 ) mothers were derived and subsequently interviewed . The high-anxiety mothers were r and omly assigned to a professional intervention , to a non-professional intervention , and to a control group , and their progress was review ed over the following 12 months . Compliance , both in responding to progressive assessment s and in accepting therapeutic intervention , was extremely high . Changes in anxiety levels for mothers not receiving an intervention were minimal over the study . In the high-anxiety sub-groups , there was a 19 % reduction in state anxiety levels for those receiving a professional intervention , a 12 % reduction for those receiving a non-professional intervention , and a 3 % reduction in the controls . A planned contrast analysis determined that only professional intervention had a significant effect , intervention successfully lowering state anxiety levels to a value comparable with the moderately anxious mothers BACKGROUND : Treatment side effects after radical prostatectomy include urinary , sexual , and bowel dysfunction . These functional declines , coupled with the bother associated with these dysfunctions , lead to a complicated pattern of change in quality -of-life and decreased self-efficacy . METHODS : In this study , 72 men who underwent radical prostatectomy 6-weeks prior were r and omly assigned to usual health care control group or peer-to-peer support ( dyadic support ) group . The dyadic meetings were held once a week for 8 weeks . Measured pre- and post-test was general health-related quality -of-life ( SF-36 ) , prostate cancer-specific quality -of-life ( UCLA Prostate Cancer Index ) , and self-efficacy ( Stanford Inventory of Cancer Patient Adjustment ) . RESULTS : By 8 weeks , self-efficacy significantly improved for men in the experimental group , but not for men in the control group . A series of logistic regression analyses showed that the dyadic intervention significantly accounted for changes in physical role functioning , bowel function , mental health , and social function . Age , education , and self-efficacy had significant interaction effects and increased the effects of the dyadic intervention on several outcomes . CONCLUSIONS : The intervention had a significant impact on how men react socially and emotionally to the side effects of radical prostatectomy Study objective : To evaluate the effect of two forms of postnatal social support for disadvantaged inner city mothers on  maternal and child health outcomes . Design : R and omised controlled trial with economic and process evaluations and follow up at 12 and 18 months . The two intervention groups received either the offer of a year of monthly supportive listening home visits by a support health visitor ( SHV ) , or a year of support from community groups providing drop in sessions , home visiting and /or telephone support ( CGS ) . Each was compared with a control group that received st and ard health visitor services . Setting : Two disadvantaged boroughs of London , United Kingdom . Participants : 731 women from culturally diverse background s with infants . Main results : At 12 and 18 months , there was little impact for either intervention on the main outcomes : child injury ( SHV : relative risk 0.99 ; 95 % confidence intervals 0.68 to 1.45 , CGS : 0.91 ; 0.61 to1.36 ) , maternal smoking ( SHV : 0.86 ; 0.62 to 1.19 , CGS : 0.97 ; 0.72 to 1.33 ) or maternal depression ( SHV : 0.86 ; 0.62 to1.19 , CGS : 0.93 ; 0.69 to 1.27 ) . SHV women had different patterns of health service use ( with fewer taking their children to the GP ) and had less anxious experiences of motherhood than control women . User satisfaction with the SHV intervention was high . Uptake of the CGS intervention was low : 19 % , compared with 94 % for the SHV intervention . Conclusions : There was no evidence of impact on the primary outcomes of either intervention among this culturally diverse population . The SHV intervention was associated with improvement in some of the secondary outcomes BACKGROUND Previous studies in non clinical sample s have shown psychosocial treatments to be efficacious in the treatment of adolescent depression , but few psychotherapy treatment studies have been conducted in clinical ly referred , depressed adolescents . METHODS One hundred seven adolescent patients with DSM-III-R major depressive disorder ( MDD ) were r and omly assigned to 1 of 3 treatments : individual cognitive behavior therapy , systemic behavior family therapy ( SBFT ) , or individual nondirective supportive therapy ( NST ) . Treatments were 12 to 16 sessions provided in as many weeks . Intent-to-treat analyses were conducted using all follow-up data . RESULTS Of the 107 patients enrolled in the study , 78 ( 72.9 % ) completed the study , 4 ( 3.7 % ) never initiated treatment , 10 ( 9.3 % ) had exclusionary criteria that were undetected at entry , 8 ( 7.5 % ) dropped out , and 7 ( 6.5 % ) were removed for clinical reasons . Cognitive behavior therapy showed a lower rate of MDD at the end of treatment compared with NST ( 17.1 % vs 42.4 % ; P = .02 ) , and result ed in a higher rate of remission ( 64.7 % , defined as absence of MDD and at least 3 consecutive Beck Depression Inventory scores < 9 ) than SBFT ( 37.9 % ; P = .03 ) or NST ( 39.4 % ; p = .04 ) . Cognitive behavior therapy result ed in more rapid relief in interviewer-rated ( vs both treatments , P = .03 ) and self-reported depression ( vs SBFT , P = .02 ) . All 3 treatments showed significant and similar reductions in suicidality and functional impairment . Parents ' views of the credibility of cognitive behavior therapy improved compared with parents ' views of both SBFT ( P = .01 ) and NST ( P = .05 ) . CONCLUSIONS Cognitive behavior therapy is more efficacious than SBFT or NST for adolescent MDD in clinical setting s , result ing in more rapid and complete treatment response Background Despite a growing underst and ing of the effectiveness of bereavement interventions and the groups that benefit most from them , we know little about the cost-effectiveness of bereavement interventions . Methods We conducted a cost-utility analysis alongside a r and omized clinical trial on a visiting service for older widowed individuals ( n = 110 ) versus care as usual ( CAU ; n = 106 ) .  The visiting service is a selective bereavement intervention that offers social support to lonely widows and widowers by a trained volunteer . Participants were contacted 6–9 months post-loss . Eleven percent of all contacted persons responded and eight percent participated in the trial . The primary outcome measure was quality adjusted life years ( QALYs ) gained ( assessed with the EQ-5D ) , which is a generic measure of health status . Costs were calculated from a societal perspective excluding costs arising from productivity losses . Using the bootstrap method , we obtained the incremental cost utility ratio ( ICUR ) , projected these on a cost-utility plane and presented as an acceptability curve . Results Overall , the experimental group demonstrated slightly better results against slightly higher costs . Whether the visiting service is acceptable depends on the willingness to pay : at a willingness to pay equal to zero per QALY gained , the visiting service has a probability of 31 % of being acceptable ; beyond € 20,000 , the visiting service has a probability of 70 % of being more acceptable than CAU . ConclusionS elective bereavement interventions like the visiting service will not produce large benefits from the health economic point of view , when targeted towards the entire population of all widowed individuals . We recommend that in depth analyses are conducted to identify who benefits most from this kind of interventions , and in what subgroups the incremental cost-utility is best . In the future bereavement interventions are then best directed to these groups . Trial registration Controlled trials IS RCT Background : Older adults after myocardial infa rct ion ( MI ) are a vulnerable group who may benefit from interventions to improve health outcomes . The use of a peer advisor or an advanced practice nurse ( APN ) to provide a self-efficacy intervention is a promising method of improving health outcomes after MI . Aims : The purpose of this paper was to compare the effect of two self-efficacy interventions , a peer advisor and an APN , to a group who received st and ard care after MI . Methods : The study was a three-group r and omized clinical trial with a peer advisor intervention group , an APN intervention group , and a st and ard care group . Outcome data were collected in the hospital after MI and by telephone at 12 weeks after hospital discharge , after the interventions were completed . Results : At 12 weeks after MI , there were no significant differences between the 3 groups in health outcomes . There were similar changes in self-efficacy for performing recovery behaviors , the actual performance of recovery behavior , physical and mental health across both intervention groups and the st and ard care group . Conclusions : Although the data did not vali date the benefits of these self-efficacy interventions , future efforts at identifying changes in health outcomes may need to use more discrete measurements that are more sensitive to changes in the older unpartnered adult after an MI Objective To evaluate the effectiveness of a voluntary sector based befriending scheme in improving psychological wellbeing and quality of life for family carers of people with dementia . Design Single blind r and omised controlled trial . Setting Community setting s in East Anglia and London . Participants 236 family carers of people with primary progressive dementia . Intervention Contact with a befriender facilitator and offer of match with a trained lay volunteer befriender compared with no befriender facilitator contact ; all participants continued to receive “ usual care . ” Main outcome measures Carers ’ mood ( hospital anxiety and depression scale — depression ) and health related quality of life ( EuroQoL ) at 15 months post-r and omisation . Results The intention to treat analysis showed no benefit for the intervention “ access to a befriender facilitator ” on the primary outcome measure or on any of the secondary outcome measures . Conclusions In common with many carers ’ services , befriending schemes are not taken up by all carers , and providing access to a befriending scheme is not effective in improving wellbeing . Trial registration Current Controlled Trials IS RCT N08130075 Urinary and sexual dysfunctions are side effects of radical prostatectomy ( RP ) for prostate cancer ( PC ) that contribute to depression . Despite the effectiveness of support groups at reducing depression in cancer patients , men typically do not participate in them . The purpose of this pilot study was to test the effects of a dyadic intervention ( one-to-one support ) on social support  ( Modified Inventory of Socially Supportive Behaviors ) , self-efficacy ( Stanford Inventory of Cancer Patient Adjustment ) , and depression ( Geriatric Depression Scale ) .  Subjects were r and omized to group . Controls ( N=15 ; Mage=59.7 ) received usual care . Experimentals were paired with long-term survivors ( LTS ) who had RP and who had treatment side effects in common . Experimentals ( N=15 ; Mage=57.5 ) met with a LTS 8 times in 8 weeks to discuss concerns associated with survivorship . No significant differences were detected on social support , but after 4 weeks , significant differences were present on depression between controls and experimentals , however these differences were not seen at 8 weeks . After 8 weeks , there were also significant differences on self-efficacy between controls and experimentals . Weekly anecdotal data supported the feasibility and acceptance of the intervention that was a low cost strategy effective at reducing depression and increasing self-efficacy in men treated by RP . Future research directions and clinical application is presented BACKGROUND Family caregivers experience considerable stress in their management of specific behaviors of persons with dementia . OBJECTIVE To examine the effects of an 8-week cognitive-behavioral ( C-B ) intervention tailored to the specific deficits of persons with dementia ( PWDs ) on selected outcomes for homebound caregivers and the functional status of the PWD . METHOD The design was a two-group r and omized trial with measures taken at baseline , 4 weeks , 8 weeks , and 12 weeks . Subjects were 65 caregiver-care recipient dyads . A majority of the 65 female caregivers were spouses with a mean age of 66.5 years . Thirty-one women who received the C-B intervention  were compared to 34 who received the  attention-only ( A-O ) placebo telephone calls .  Coping strategies , perceptions of caregiver burden and satisfaction , and emotional and physical health were assessed at the four points in time . RESULTS Results indicated a time by group interaction in depression , with less depression in the C-B than the A-O group . Both groups experienced a significant reduction in anxiety , and a significant consistent decrease in satisfaction over time . Both groups also demonstrated decreased use of emotion-focused coping strategies . CONCLUSION The results suggest a plausible effectiveness of the C-B intervention in preventing the progression of depression . Suggestions for future research are provided Forty-nine nursing home residents were r and omly assigned to a visitation condition focusing on conversational interaction , a visitation condition in which the playing of cognitively challenging games supplemented conversation , or a no-treatment control condition . Each subject in a visitation condition was visited by an undergraduate student twice per week for 8 weeks . Before and after the visitation period , all subjects were given four tests of cognitive functioning ( vocabulary , matrices , memory , problem-solving ) , three tests of morale ( Life Satisf 
    Output:
    
Befriending has a modest effect on depressive symptoms and emotional distress in varied patient groups .