***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: Introduction : Chinese is the world ’s largest ethnic group but few health-related quality of life ( HRQoL ) measures have been tested on them . The aim of this study was to determine if the st and ard SF-12 was valid and equivalent for a Chinese population . Methods : The SF-36 data of 2410 Chinese adults r and omly selected from the general population of Hong Kong ( HK ) were analysed . The Chinese ( HK ) specific SF-12 items and scoring algorithm were derived from the HK Chinese population data by multiple regressions . The SF-36 PCS and MCS scores were used as criteria to assess the content and criterion validity of the SF-12 . The st and ard and Chinese ( HK ) specific SF-12 PCS and MCS scores were compared for equivalence . Results : The st and ard SF-12 explained 82 % and 89 % of the variance of the SF-36 PCS and MCS scores , respectively , and the effect size differences between the st and ard SF-36 and SF-12 scores were less than 0.3 . Six of the Chinese ( HK ) specific SF-12 items were different from those of the st and ard SF-12 , but the effect size differences between the Chinese ( HK ) specific and st and ard SF-12 scores were mostly less than 0.3 . Conclusions : The st and ard SF-12 was valid and equivalent for the Chinese , which would enable more Chinese to be included in clinical trials that measure OBJECTIVES To examine the relationships between changes from baseline to post-Re sources for Enhancing Alzheimer 's Caregiver Health ( REACH ) intervention in caregiver ( CG ) self-reported health , burden , and bother . DESIGN R and omized , multisite clinical trial . SETTING CG and care recipient ( CR ) homes in five U.S. cities . PARTICIPANTS Four hundred ninety-five dementia CG and CR dyads ( 169 Hispanic , 160 white , and 166 African American ) receiving intervention and their controls . INTERVENTION CGs were assigned to the REACH intervention or a no-treatment control group . Intervention subjects received individual risk profiles and the REACH intervention through nine in-home and three telephone sessions over 6 months . Control subjects received two brief " check-in " telephone calls during this 6-month period . MEASUREMENTS The primary outcome was change in CG health status from baseline to after the intervention . Secondary outcomes were CG burden and bother after the intervention . RESULTS After the intervention , CGs reported better self-rated health , sleep quality , physical health , and emotional health , which was related to less burden and bother with their caregiving role than for CGs not receiving the intervention . Changes in depression appeared to mediate these relationships . Several racial and ethnic group differences existed in physical and emotional health , as well as in total frustration with caregiving , emotional burden , and CG-rated bother with CR 's activities of daily living and instrumental activities of daily living at baseline and at follow-up , although differences between baseline and posttest did not vary according to race . CONCLUSION A structured , multicomponent skills training intervention that targeted CG self-care behaviors as one of five target areas , improved self-reported health status , and decreased burden and bother in racially and ethnically diverse CGs of people with dementia Background : Caregivers of people with chronic conditions are more likely than non-caregivers to have depression and emotional problems .  Few studies have examined the effectiveness of mindfulness-based stress reduction ( MBSR ) in improving their mental well-being . Methods : Caregivers of persons with chronic conditions who scored 7 or above in the Caregiver Strain Index were r and omly assigned to the 8-week MBSR group ( n = 70 ) or the self-help control group ( n = 71 ) . Vali date d instruments were used to assess the changes in depressive and anxiety symptoms , quality of life , self-efficacy , self-compassion and mindfulness . Assessment s were conducted at baseline , post-intervention and at the 3-month follow-up . Results : Compared to the participants in the control group , participants in the MBSR group had a significantly greater decrease in depressive symptoms at post-intervention and at 3 months post-intervention ( p < 0.01 ) . The improvement in state anxiety symptoms was significantly greater among participants in the MBSR group than those of the control group at post-intervention ( p = 0.007 ) , although this difference was not statistically significant at 3 months post-intervention ( p = 0.084 ) . There was also a statistically significant larger increase in self-efficacy ( controlling negative thoughts ; p = 0.041 ) and mindfulness ( p = 0.001 ) among participants in the MBSR group at the 3-month follow-up compared to the participants in the control group . No statistically significant group effects ( MBSR vs. control ) were found in perceived stress , quality of life or self-compassion . Conclusions : MBSR appears to be a feasible and acceptable intervention to improve mental health among family caregivers with significant care burden , although further studies that include an active control group are needed to make the findings more conclusive Objectives : The majority of care for those with Alzheimer 's disease and other age-related dementias is provided in the home by family members . To date , there is no consistently effective intervention for reducing the significant stress burden of many family caregivers . The present pilot r and omized controlled trial tested the efficacy of an adapted , eight-week mindfulness-based stress reduction ( MBSR ) program , relative to a near structurally equivalent , st and ard social support ( SS ) control condition for reducing caregiver stress and enhancing the care giver – recipient relationship . Method : Thirty-eight family caregivers were r and omized to MBSR or SS  , with measures of diurnal salivary cortisol , and perceived stress , mental health , experiential avoidance , caregiver burden , and relationship quality collected pre- and post-intervention and at three-month follow-up . Results : MBSR participants reported significantly lower levels of perceived stress and mood disturbance at post-intervention relative to SS participants . At three-month follow-up , participants in both treatment conditions reported improvements on several psychosocial outcomes . At follow-up , there were no condition differences on these outcomes , nor did MBSR and SS participants differ in diurnal cortisol response change over the course of the study . Conclusion : Both MBSR and SS showed stress reduction effects , and MBSR showed no sustained neuroendocrine and psychosocial advantages over SS . The lack of treatment condition differences could be attributable to active ingredients in both interventions , and to population -specific and design factors BACKGROUND This study examined the effects of brief daily yogic meditation on mental health , cognitive functioning , and immune cell telomerase activity in family dementia caregivers with mild depressive symptoms . METHODS Thirty-nine family dementia caregivers ( mean age 60.3 years old ( SD = 10.2 ) ) were r and omized to practicing Kirtan Kriya or listening to relaxation music for 12 min per day for 8 weeks . The severity of depressive symptoms , mental and cognitive functioning were assessed at baseline and follow-up . Telomerase activity in peripheral blood mononuclear cells ( PMBC ) was examined in peripheral P BMC pre-intervention and post-intervention . RESULTS The meditation group showed significantly lower levels of depressive symptoms and greater improvement in mental health and cognitive functioning compared with the relaxation group . In the meditation group , 65.2 % showed 50 % improvement on the Hamilton Depression Rating scale and 52 % of the participants showed 50 % improvement on the Mental Health Composite Summary score of the Short Form-36 scale compared with 31.2 % and 19 % , respectively , in the relaxation group ( p < 0.05 ) . The meditation group showed 43 % improvement in telomerase activity compared with 3.7 % in the relaxation group ( p = 0.05 ) . CONCLUSION This pilot study found that brief daily meditation practice s by family dementia caregivers can lead to improved mental and cognitive functioning and lower levels of depressive symptoms . This improvement is accompanied by an increase in telomerase activity suggesting improvement in stress-induced cellular aging . These results need to be confirmed in a larger sample Flaws in the design , conduct , analysis , and reporting of r and omised trials can cause the effect of an intervention to be underestimated or overestimated . The Cochrane Collaboration ’s tool for assessing risk of bias aims to make the process clearer and more Stress is implicated in the pathogenesis and progression of HIV . The Transcendental Meditation ( TM ) is a behavioral stress reduction program that incorporates mind – body approach , and has demonstrated effectiveness in improving outcomes via stress reduction . We evaluated the feasibility of implementing TM and its effects on outcomes in persons with HIV . In this community-based single blinded Phase-I , r and omized controlled trial , outcomes ( psychological and physiological stress , immune activation , generic and HIV-specific health-related quality of life , depression and quality of well-being ) were assessed at baseline and at six months , and were compared using parametric and nonparametric tests . Twenty-two persons with HIV were equally r and omized to TM intervention or healthy eating ( HE ) education control group .  Retention was 100 % in TM group and 91 % in HE control group . The TM group exhibited significant improvement in vitality . Significant between group differences were observed for generic and HIV-specific health-related quality of life . Small sample size may possibly limit the ability to observe significant differences in some outcomes . TM stress reduction intervention in community dwelling adults with HIV is viable and can enhance health-related quality of life . Further research with large sample and longer follow-up is needed to vali date our results Context Providing care for patients with dementia can pose enormous burdens that may be eased with assistance and support . Needs may differ by race or ethnicity . Contributions The investigators r and omly assigned Hispanic , black , and white dementia caregivers to receive written educational material s or an intensive intervention to improve caregiver quality of life .  The specific interventions were determined by caregivers , were delivered via trained personnel and telephone support groups , and targeted several dimensions of need . The study found that quality of life improved for Hispanic and white caregivers and for black spousal caregivers in the intervention group but not in the control group . The intervention had no detectable effect on the number of care recipients who were institutionalized . Caution s The study used only a single 6-month follow-up assessment , combined heterogeneous cultures and ethnicities into 3 groups , and excluded some ethnicities . Implication s An intensive intervention targeting several dimensions of caregiver need improved caregiver quality of life without an apparent effect on care recipient institutionalization . The effect did not differ by caregiver race or ethnicity . The Editors Caring for a family member with dementia is extremely stressful , contributes to psychiatric and physical illness , and increases the risk for death ( 1 , 2 ) . The accumulating evidence on the personal , social , and health effects of dementia caregiving has generated a broad range of intervention studies , including r and omized trials aim ed at decreasing the burden and stress of caregiving . Several studies have demonstrated statistically significant effects in reducing caregiver burden , lowering caregiver depression , and delaying institutionalization of care recipients ( 1 , 3 , 4 ) through either targeted interventions that treat a specific caregiver problem , such as depression , or broad-based multicomponent interventions that include counseling , case management , and telephone support . Persistent limitations of caregiver intervention research are the paucity of well-controlled r and omized trials , the limited range of outcomes examined , small sample sizes and insufficient power , geographic limitations , inadequate racial or ethnic variation , and a scarcity of comprehensive multicomponent interventions ( 4 ) . Indeed , none of the 41 r and omized clinical trials published in the last 5 years met Consoli date d St and ards of Reporting Trials ( CONSORT ) recommendations for reporting r and omized trials ( 5 ) , and many have serious method ologic problems that call into question the reported findings ( 4 ) . To address these limitations , the National Institute on Aging and the National Institute of Nursing Research funded a multisite research program design ed to develop and test an effective caregiver intervention : the Re sources for Enhancing Alzheimer 's Caregiver Health ( REACH ) study . We performed the study in 2 phases . In the first phase ( REACH I ) , we tested several different interventions at 6 U.S. sites to identify the most promising approaches to decreasing  caregiver burden and depression ( 6 ) . Results from the study showed that active treatments were superior to control conditions in reducing caregiver burden and that active engagement in skills training statistically significantly reduced  caregiver depression ( 7 , 8) . The existing literature and findings from REACH I helped guide the design of the REACH II intervention ( 7 , 8) . We based the REACH II study on the premise that caregivers can have problems in several areas at varying levels of intensity , and thus , interventions must be responsive to variations in needs among caregivers . The findings from REACH I also suggest that interventions that use active techniques , such as role-playing and interactive practice , are more effective at improving outcomes , such as depression symptoms , compared with more passive methods , such as providing information ( 7 ) . We based the REACH II intervention on these assumptions and design ed the intervention to maximize outcomes by systematic ally targeting several problem areas , tailored the intervention to respond to the needs of each individual , and actively engaged the caregiver in the intervention process . We hypothesized that participants assigned to the intervention would do better than those in the control group on several indicators of caregiver quality of life , including depression , burden , self-care , and social support and care recipient problem behaviors , and that these differences would be largest among Hispanic or Latino persons because 
    Output:
    
Pooled evidence did not show a significant advantage of mindfulness training compared with control conditions in the alleviation of caregiver burden or anxiety .