***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: AIMS AND OBJECTIVES To investigate the efficacy of acupressure in decreasing agitated behaviours associated with dementia . BACKGROUND Agitated behaviour is found in nearly half of all patients who have dementia . The presence of these behaviours increases the likelihood of injury , weakness , dehydration and lack of sleep and contributes to caregiver frustration and fatigue . DESIGN This pilot study was design ed with subjects receiving both acupressure and the control treatment .  Each subject served as his or her own control . Subjects received four weeks of acupressure protocol s ; to avoid a carry-over effect there was a treatment-free period of one week . Subjects then were visited by one of the investigators for a six-week period . METHODS Participants were recruited from a nursing home caring specifically for patients with dementia . Twenty of the 31 subjects ( 64.5 % ) completed the study , while 11 were discharged or hospitalized . All the subjects were assigned to an experimental protocol and had a six-week acupressure treatment program . Baseline data were collected in the first week . Individual treatment sessions began at the second week of the study and lasted 15 minutes , twice a day , five days a week for four weeks . After a treatment-free period of one week , all the subjects served as controls undergoing a four-week control protocol consisting of companionship and conversation . RESULTS Comparison between the control and experimental phases indicated significant differences between the two groups on all outcome measures ( Cohen-Mansfield Agitation Inventory , daily agitation records about physical attack , verbal and non-verbal attack and non-physical attack ) with better results found during the acupressure phase . CONCLUSIONS Acupressure is recommended as an efficacious and non-intrusive method for decreasing the agitation behaviours in patients with dementia . RELEVANCE TO CLINICAL PRACTICE Conducting the acupressure treatment takes 15 minutes . It could provide caregivers with a viable alternative to deal with patients with dementia Alzheimer 's disease is characterized by progressive cognitive decline . However , little is known about the " typical " rate of decline , the degree of individual heterogeneity evident in decline , or the types of factors that influence such decline . This study investigated these questions in a sample of 106 patients with Alzheimer 's disease , assessed at 1 - 5 points in time , spanning up to three years . At each time point , the  Mini-Mental State Exam , a measure of global cognitive function , was administered to all patients . Measures of behavioral disturbance ( including the presence/absence of hallucinations , depression , incontinence , w and ering , and agitation ) , health status ( including presence/absence of neurological , cardiovascular , and other diseases ) , and descriptive information ( such as gender , age at time of onset , and duration of deficits ) were obtained at entry into the study . A two-stage r and om effects regression model was fit to the data and then used to assess the effect of these behavioral , health , and descriptive measures on the rate of decline . Results indicate that the rate of cognitive decline in Alzheimer 's disease is quite variable . Patients with various health and behavioral problems declined at a rate between 1.4 and 5 times faster than patients without such problems . Alcohol abuse , additional neurological disease , and agitation were significantly related to rate of decline . Overall number of problems was not . The association of these problems with accelerated decline may have prognostic and treatment implication Background Disruptive behaviors are prevalent in nursing home residents with dementia and often have negative consequences for the resident , caregiver , and others in the environment . Behavioral interventions might ameliorate them and have a positive effect on residents ’ mood ( affect ) . Objectives This study tested two interventions —an activities of daily living and a psychosocial activity intervention— and a combination of the two to determine their efficacy in reducing disruptive behaviors and improving affect in nursing home residents with dementia . Methods The study had three treatment groups ( activities of daily living , psychosocial activity , and a combination ) and two control groups ( placebo and no intervention ) . Nursing assistants hired specifically for this study enacted the interventions under the direction of a master ’s prepared gerontological clinical nurse specialist . Nursing assistants employed at the nursing homes recorded the occurrence of  disruptive behaviors  . Raters analyzed videotapes filmed during the study to determine the interventions ’ influence on affect . Results Findings indicated significantly more positive affect but not reduced disruptive behaviors in treatment groups compared to control groups . Conclusions The treatments did not specifically address the factors that may have been triggering disruptive behaviors . Interventions much more precisely design ed than those employed in this study require development to quell disruptive behaviors . Nontargeted interventions might increase positive affect . Treatments that produce even a brief improvement in affect indicate improved quality of mental health as m and ated by federal law Background : Treatment of agitation is a crucial problem in the care of patients with AD . Although antipsychotic and antidepressant medications and behavior management techniques ( BMT ) have each been used to treat agitation , clinical trials of these treatments have been characterized by small sample sizes and uncontrolled treatment design s. Objective : To compare haloperidol , trazodone , and BMT with placebo in the treatment of agitation in AD out patients . Methods : A total of 149 patients with AD and their caregivers participated in a r and omized , placebo-controlled , multicenter trial . Blind assessment was conducted at baseline and after 16 weeks of treatment . The three active treatments were haloperidol , trazodone , and BMT . The Alzheimer ’s Disease Cooperative Study Clinical Global Impression of Change was the primary outcome measure . Secondary outcomes included patient agitation , cognition , and function , and caregiver burden . Results : Thirty-four percent of subjects improved relative to baseline . No significant differences on outcome were obtained between haloperidol ( mean dose , 1.8 mg/d ) , trazodone ( mean dose , 200 mg/d ) , BMT , or placebo . Significantly fewer adverse events of bradykinesia and parkinsonian gait were evident in the BMT arm . No other significant difference in adverse events was seen . Symptoms did not respond differentially to the different treatments . Conclusions : Comparable modest reductions in agitation occurred in patients receiving haloperidol , trazodone , BMT , and placebo .  More effective pharmacologic , nonpharmacologic , and combination treatments are needed 
    Output:
    
Types of outcome measures : Studies will be included if they have assessed the effects of a strategy on the following outcomes : 1 .
severity of agitated behaviours 2 .
frequency of agitated behaviours 3 .
use of pharmacotherapy in relation to agitated