***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: BACKGROUND Subthreshold depression is a highly prevalent condition and a risk factor for developing a major depressive episode . Internet-based cognitive behaviour therapy may be a promising approach for the treatment of subthreshold depression . The current study had two aims : ( 1 ) to determine whether an internet-based cognitive behaviour therapy intervention and a group cognitive behaviour therapy intervention are more effective than a waiting-list control group ; and ( 2 ) to determine whether the effect of the internet-based cognitive behaviour therapy differs from the group cognitive behaviour therapy intervention . METHOD A total of 191 women and 110 men with subthreshold depression were r and omized into internet-based treatment , group cognitive behaviour therapy ( Lewinsohn 's Coping With Depression course ) , or a waiting-list control condition . The main outcome measure was treatment response after 10 weeks , defined as the difference in pre- and post-treatment scores on the Beck Depression Inventory ( BDI ) . Missing data , a major limitation of this study , were imputed using the Multiple Imputation ( MI ) procedure Data Augmentation . RESULTS In the waiting-list control group , we found a pre- to post-improvement effect size of 0.45 , which was 0.65 in the group cognitive behaviour therapy condition and 1.00 within the internet-based treatment condition . Helmert contrasts showed a significant difference between the waiting-list condition and the two treatment conditions ( p=0.04 ) and no significant difference between both treatment conditions ( p=0.62 ) . CONCLUSIONS An internet-based intervention may be at least as effective as a commonly used group cognitive behaviour therapy intervention for subthreshold depression in people over 50 years of age Objective : The aim of this study is to evaluate the effectiveness of life review ( LR ) based on specific positive events in non-depressed older adults taking part in an active aging program . Method : Fifty-five older adults were r and omly assigned to an experimental group or an active control ( AC ) group . A six-session individual training of LR based on specific positive events was carried out with the experimental group . The AC group undertook a “ media workshop ” of six sessions focused on learning journalistic techniques . Pre-test and post-test measures included life satisfaction , depressive symptoms , experiencing the environment as rewarding , and autobiographical memory ( AM ) scales . Results : LR intervention decreased depressive symptomatology , improved life satisfaction , and increased specific memories . Discussion : The findings suggest that practice in AM for specific events is an effective component of LR that could be a useful tool in enhancing emotional well-being in active aging programs , thus reducing depressive symptoms Purpose Research on effectiveness of low-threshold mobility interventions that are viable for users of residential aged care is scarce . Low-threshold is defined as keeping dem and s on organizations ( staff skills , costs ) and participants ( health status , discipline ) rather low . The study explored the effectiveness of a multi-faceted , low-threshold physical activity program in three residential aged-care facilities in Austria . Main goals were enhancement of mobility by conducting a multi-faceted training program to foster occupational performance and thus improve different aspects of health-related quality of life ( QoL ) . Participants and methods The program consisted of a weekly session of 60 minutes over a period of 20 weeks . A st and ardized assessment of mobility status and health-related QoL was applied before and after the intervention . A total of 222 of 276 participants completed the r and omized controlled trial study ( intervention group n=104 , control group n=118 ; average age 84 years , 88 % female ) . Results Subjective health status ( EuroQoL-5 dimensions : P=0.001 , d=0.36 ) improved significantly in the intervention group , and there were also positive trends in occupational performance ( Canadian Occupational Performance Measure ) . No clear effects were found concerning the functional and cognitive measures applied . Conclusion Thus , the low-threshold approach turned out to be effective primarily on subjective health-related QoL. This outcome could be a useful asset for organizations offering low-threshold physical activity interventions UNLABELLED There is preliminary support for internet-delivered cognitive behaviour therapy ( iCBT ) as a way of improving access to treatment among older adults with anxiety . The aim of this r and omized controlled trial ( RCT ) was to examine the efficacy , long-term outcomes , and cost-effectiveness of an iCBT program for adults over 60 years of age with anxiety . Successful applicants were r and omly allocated to either the treatment group ( n=35 ) or the waitlist control group ( n=37 ) . The online treatment course was delivered over 8 weeks and provided with brief weekly contact with a clinical psychologist via telephone or secure email . Eighty-four percent of participants completed the iCBT course within the 8 weeks and 90 % provided data at posttreatment . Significantly lower scores on measures of anxiety ( Cohen 's d=1.43 ; 95 % CI : 0.89 - 1.93 ) and depression ( Cohen 's d=1.79 ; 95 % CI : 1.21 - 2.32 ) were found among the treatment group compared to the control group at posttreatment . These lower scores were maintained at 3-month and 12-month follow-up and the treatment group rated the iCBT treatment as acceptable . The treatment group had slightly higher costs ( $ 92.2 ; 95 % CI : $ 38.7 to $ 149.2 ) and Quality -Adjusted Life-Years ( QALYs=0.010 ; 95 % CI : 0.003 to 0.018 ) than the control group at posttreatment and the intervention was found to have a greater than 95 % probability of being cost-effective . The results support iCBT as an efficacious and cost-effective treatment option for older adults with symptoms of anxiety  . TRIAL REGISTRATION TRIAL REGISTRATION Australian and New Zeal and Clinical Trials Registry : ACTRN12611000929909 ; https://www.anzctr.org.au/Trial/ Registration /Trial Review .aspx?ACTRN=12611000929909 Background Older people are at risk for health decline and loss of independence . Lifestyle interventions offer potential for reducing such negative outcomes . The aim of this study was to determine the effectiveness and cost-effectiveness of a preventive lifestyle-based occupational therapy intervention , administered in a variety of community-based sites , in improving mental and physical well-being and cognitive functioning in ethnically diverse older people . Methods A r and omised controlled trial was conducted comparing an occupational therapy intervention and a no-treatment control condition over a 6-month experimental phase . Participants included 460 men and women aged 60–95 years ( mean age 74.9±7.7 years ; 53 % < $ 12 000 annual income ) recruited from 21 sites in the greater Los Angeles metropolitan area . Results Intervention participants , relative to untreated controls , showed more favourable change scores on indices of bodily pain , vitality , social functioning , mental health , composite mental functioning , life satisfaction and depressive symptomatology ( ps<0.05 ) . The intervention group had a significantly greater increment in quality -adjusted life years ( p<0.02 ) , which was achieved cost-effectively ( US $ 41 218/UK £ 24 868 per unit ) . No intervention effect was found for cognitive functioning outcome measures . Conclusions A lifestyle-oriented occupational therapy intervention has beneficial effects for ethnically diverse older people recruited from a wide array of community setting s. Because the intervention is cost-effective and is applicable on a wide-scale basis , it has the potential to help reduce health decline and promote well-being in older people . Trial Registration clinical trials.gov identifier : NCT0078634 A cluster r and omized controlled trial showed that the Resident Assessment Instrument ( RAI ) could not improve or stabilize the health status of people in need of long-term care or reduce the rate of institutionalization in Germany among clients of home care agencies . The aim of this article is to investigate whether the effect of RAI depends on the degree of implementation . A factor analysis was used to distinguish between those agencies that implemented RAI intensively and those that did not . The clients of home care agencies working intensively with RAI were significantly less hospitalized ( P = 0.0284 ) and fared slightly better according to activities of daily living ( ADL , instrumental ADL ( IADL ) ) , cognitive skills ( Mini-Mental Status Test ( MMST ) ) and quality of life ( EuroQol ( EQ-5D ) ) compared with the control group . In contrast , those not working intensively with RAI had worse outcomes ( IADL , MMST , EQ-5D ) than the control group ( not significant ) . It is important to guarantee a successful implementation of RAI Objective To assess the effectiveness of an activity programme in improving function , quality of life , and falls in older people in residential care . Design Cluster r and omised controlled trial with one year follow-up . Setting 41 low level dependency residential care homes in New Zeal and . Participants 682 people aged 65 years or over . Interventions 330 residents were offered a goal setting and individualised activities of daily living activity programme by a gerontology nurse , reinforced by usual healthcare assistants ; 352 residents received social visits . Main outcome measures Function ( late life function and disability instruments , elderly mobility scale , FICSIT-4 balance test , timed up and go test ) , quality of life ( life satisfaction index , EuroQol ) , and falls ( time to fall over 12 months ) . Secondary outcomes were depressive symptoms and hospital admissions . Results 473 ( 70 % ) participants completed the trial . The programme had no impact overall . However , in contrast to residents with impaired cognition ( no differences between intervention and control group ) , those with normal cognition in the intervention group may have maintained overall function ( late life function and disability instrument total function , P=0.024 ) and lower limb function ( late life function and disability instrument basic lower extremity , P=0.015 ) . In residents with cognitive impairment , the likelihood of depression increased in the intervention group . No other outcomes differed between groups . Conclusion A programme of functional rehabilitation had minimal impact for elderly people in residential care with normal cognition but was not beneficial for those with poor cognition . Trial registration Australian Clinical Trials Register ACTRN12605000667617 CONTEXT Given the public health significance of late-life depression and anxiety , and the limited capacity of treatment , there is an urgent need to develop effective strategies to prevent these disorders . OBJECTIVE To determine the effectiveness of an indicated stepped-care prevention program for  depression and anxiety disorders in the elderly . DESIGN R and omized controlled trial with recruitment between October 1 , 2004 , and October 1 , 2005 . SETTING Thirty-three primary care practice s in the northwestern part of the Netherl and s. PARTICIPANTS A total of 170 consenting individuals , 75 years and older , with subthreshold symptom levels of depression or anxiety who did not meet the full diagnostic criteria for the disorders . INTERVENTION Participants were r and omly assigned to a preventive stepped-care program ( n = 86 ) or to usual care ( n = 84 ) . Stepped-care participants sequentially received a watchful waiting approach , cognitive behavior therapy-based bibliotherapy , cognitive behavior therapy-based problem-solving treatment , and referral to primary care for medication , if required . MAIN OUTCOME MEASURES The cumulative incidence of DSM-IV major depressive disorder or anxiety disorder after 12 months as measured using the Mini International Neuropsychiatric Interview . RESULTS The intervention halved the 12-month incidence of depressive and anxiety disorders , from 0.24 ( 20 of 84 ) in the usual care group to 0.12 ( 10 of 86 ) in the stepped-care group ( relative risk , 0.49 ; 95 % confidence interval , 0.24 to 0.98 ) . CONCLUSIONS Indicated stepped-care prevention of depression and anxiety in elderly individuals is effective in reducing the risk of onset of these disorders and is valuable as seen from the public health perspective OBJECTIVES To investigate the psychosocial effects of the companion robot , Paro , in a rest home/hospital setting in comparison to a control group . DESIGN R and omized controlled trial . Residents were r and omized to the robot intervention group or a control group that attended normal activities instead of Paro sessions . Sessions took place twice a week for an hour over 12 weeks . Over the trial period , observations were conducted of residents ' social behavior when interacting as a group with the robot . As a comparison , observations were also conducted of all the residents during general activities when the resident dog was or was not present . SETTING A residential care facility in Auckl and , New Zeal and . PARTICIPANTS Forty residents in hospital and rest home care . MEASUREMENTS Residents completed a baseline measure assessing cognitive status , loneliness , depression , and quality of life . At follow-up , residents completed a question naire assessing loneliness , depression , and quality of life . During observations , behavior was noted and collated for instances of talking and stroking the dog/robot . RESULTS In comparison with the control group , residents who interacted with the robot had significant decreases in loneliness over the period of the trial . Both the resident dog and the seal robot made an impact on the social environment in comparison to when neither was present . Residents talked to and touched the robot significantly more than the resident dog . A greater number of residents were involved in discussion about the robot in comparison with the resident dog and conversation about the robot occurred more . CONCLUSION Paro is a positive addition to this environment and has benefits for older people in nursing home care .  Paro may be able to address some of the unmet needs of older people that a resident animal may not , 
    Output:
    
Across studies , three types of common conceptual themes emerged for interventions , including : 1 ) individual characteristics ; 2 ) content and structure of the interventions ; and 3 ) implementation of the interventions .
Conclusions : No specific interventions could be recommended on the aforementioned basis .
We conclude that a number of factors are of central importance for an intervention to have the desired effect .
If these factors are considered , mental health can be successfully promoted among older adults