***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: Developing an evidence base for making public health decisions will require using data from evaluation studies with r and omized and nonr and omized design s. Assessing individual studies and using studies in quantitative research syntheses require transparent reporting of the study , with sufficient detail and clarity to readily see differences and similarities among studies in the same area . The Consoli date d St and ards of Reporting Trials ( CONSORT ) statement provides guidelines for transparent reporting of r and omized clinical trials . We present the initial version of the Transparent Reporting of Evaluations with Nonr and omized Design s ( TREND ) statement . These guidelines emphasize the reporting of theories used and descriptions of intervention and comparison conditions , research design , and methods of adjusting for possible biases in evaluation studies that use nonr and omized design PURPOSE Creative expression ( CE ) programs are emerging interventions to improve the quality of care and life of persons with dementia ( PWDs ) in long-term care setting s. However , limited empirical evidence exists to support the effectiveness of these programs . Here , we report the findings from an assessment of the impact of TimeSlips ( TS ) , a group storytelling program that encourages CE among PWDs and those who care for them . DESIGN AND METHODS Instruction in TS was provided through a 10-week on-site training . An observational study using an experimental design was conducted in 20 nursing home facilities in 2 states , 10 of which were r and omly selected to implement TS .  Two weeks after the implementation of TS at the intervention sites , we conducted 4 days of direct observation , using a time-sampling approach , of residents and staff in each facility . Using surveys , we also assessed staff job satisfaction , attitudes toward residents , and burnout . RESULTS Compared with residents in the control facilities , those in the TS facilities were more engaged and more alert . In TS facilities , there were more frequent staff-resident interactions , social interactions , and social engagement . Also , staff who participated in the TS program had more positive views of residents with dementia and devalued residents less than did the control group staff . There were no differences in staff job satisfaction and burnout among staff in the TS and non-TS facilities . IMPLICATION S Implementing the TS program in nursing facilities improves the care environment for PWDs . However , additional studies are needed to offer further insights into the mechanisms by which TS improves both staff and resident outcomes OBJECTIVE This study evaluated the impact of an eight-session training program for aged care staff  in managing dementia-related challenging behaviours .  Participation in the training program with an additional five-session peer support group was compared with both participation in training only and a wait-list control condition . METHODS Outcomes were evaluated for 90 participating staff members and 113 residents with challenging behaviours from six aged care facilities . Measures of staff attitudes and the behaviours of staff and residents were collected pre- and post-intervention , and at six month follow-up . RESULTS Staff members in both dementia training groups reported improved attitudes regarding their knowledge and skills in managing residents with challenging behaviours , immediately after the training and six months later . Facility supervisors rated the nursing performance of trained staff more positively , particularly those who participated in a peer support group . The dementia training programs , whether with or without the inclusion of peer support , did not impact on levels of staff burnout or substantially reduce the level of challenging behaviours among aged care residents . CONCLUSIONS While training programs may impact positively on staff performance , organisational characteristics of aged care facilities , including low levels of management support for staff training initiatives , limit the potential outcomes . Method ological limitations are discussed BACKGROUND Abuse of older adults may occur to a disproportionate extent in institutions . Lack of familiarity with protocol s when managing abuse once it occurs is one of the reasons why it persists . Educational interventions are one of the ways to improve knowledge and management in this area . OBJECTIVE To compare the effectiveness of attending an educational course ( Group 1 ) to printed educational material ( Group 2 ) in improving management of abuse of older people . To determine if positive attitude and low burnout scores are related to improvement . DESIGN R and omized controlled trial . SETTING North London , UK . SUBJECTS Nurses , care assistants and social workers working with older people . METHODS Staff answered question naires pre- and post-intervention . RESULTS The study was completed by 64 ( 81 % ) of staff .  Baseline scores on knowledge and management abusive scenarios were low . Those r and omized to Group 1 improved after intervention and Group 2 deteriorated ( Group 1=3.7 [ st and ard deviation=8.1 ] , ANOVA F=23.0 ; P=0.0001 and Group 2=-2.9 [ st and ard deviation=10.0 ] ) . There was a ceiling effect with those who knew more learning less . The significant independent variables in regression analysis to predict learning were being r and omized to Group 1 ( P=0.003 ; odds ratio=6.8 ; 95 % confidence interval=1.9 - 24.5 ) and low baseline knowledge and management score , ( P=0.015 , odds ratio=4.8 , confidence interval=1.4 - 16.9 ) . Most staff had a positive attitude towards people with dementia ; positive attitude score correlated with baseline knowledge , but did not predict learning . CONCLUSION Identifying , documenting and reporting abuse of older people is not carried out consistently . Whilst an educational course goes some way in improving this , it needs to be targeted to take into account the baseline knowledge BACKGROUND This study examines the effectiveness of a nursing home staff training program design ed to improve the interaction between residents with dementia and their caregivers . METHODS A three-arm cluster-r and omized and controlled population of 96 caregivers and 210 residents was used . Caregivers of the intervention group ( IG ) received a three-month training program in dementia care . Data were gathered at baseline , immediately after the training and at a six-month follow-up- assessment . Short- and long-term effects of the training program were assessed in comparison with another intervention referred to as the relaxation group ( RG ) and a wait-list control group ( CG ) . RESULTS Results indicated significant positive effects of the training program on caregivers ' knowledge immediately after the training and on the use of physical restraints at the six-month follow-up . Caregivers ' overall competence increased significantly both in the IG and in the RG . No intervention effects were found on caregivers ' level of burnout , their health complaints or on the use of sedative drugs .  Relaxation training was more successful in the reduction of caregivers ' health complaints . CONCLUSIONS Results of the study indicate both the effectiveness and the limitations of a general training program in dementia care . The complexity of the nursing home setting potentially needs more complex interventions . Ongoing and continued support of the caregivers , as well as changes in organization and environment , are more likely to be helpful in the long-term improvement in the quality of care . Future research should focus on studies of specific interventions , such as the interesting effects of relaxation training on the caregivers ' state of health PURPOSE This article reports the results of a r and omized , controlled evaluation of Partners in Caregiving in a Special Care Environment , an intervention design ed to improve communication and cooperation between staff and families of residents in nursing home dementia programs . DESIGN AND METHODS Participants included 388 family members and 384 nursing staff members recruited from 20 nursing homes , r and omly assigned to treatment and control conditions . Project staff conducted training sessions on communication and conflict-resolution techniques with two groups at the intervention sites : staff and residents ' family members , followed by a joint meeting with facility administrators . RESULTS Families , staff , residents , and facility programs in the intervention facilities all demonstrated positive outcomes from program participation . Families experienced significant improvement in communicating with staff and in staff behaviors toward them , and spouses of residents increased their care involvement . Staff reported reduced conflict with families and reduced depression ; burnout for nurses increased for individuals in the control group but not those in the treatment group . Behavioral symptoms decreased for residents , and facilities implemented more family-focused programs . IMPLICATION S Effective staff and family partnerships are critical in caring for residents with dementia . The Partners in Caregiving in a Special Care Environment program is an evidence -based intervention that enables these partnerships to develop and thrive , translating into improved experiences for residents , families , and staff Aim : To present the theoretical framework , design , methods , and baseline findings of the first Danish study on determinants and consequences of burnout , and the impact of workplace interventions in human service work organizations . Method : A 5-year prospect i ve intervention study comprising 2,391 employees from different organizations in the human service sector : social security offices , psychiatric prison , institutions for severely disabled , hospitals , and homecare services . Data were collected at baseline and at two follow-ups . The authors developed a new burnout tool ( the Copenhagen Burnout Inventory ) covering work-related , client-related , and personal burnout . The study includes potential determinants of burnout ( e.g. the psychosocial work environment , social relations outside work , lifestyle factors , and personality aspects ) and consequences of burnout ( e.g. poor health , low job satisfaction , turnover , and absenteeism ) . Here , the focus is on the description of the study population at baseline , including associations of work burnout with psychosocial work environment scales and absence . Results : Response rate at baseline was 80.1 % . Midwives and homecare workers had high levels on both work- and client-related burnout . Prison officers had the highest level on client-related burnout . Supervisors and office assistants had low levels on both scales . Work burnout showed the highest correlations with job satisfaction ( r=-0.51 ) , quantitative dem and s ( r=0.48 ) , role-conflicts ( r=0.44 ) , and emotional dem and s ( r=0.42 ) . Sickness absence was 13.9 vs 6.0 days among participants in the highest and lowest work burnout quartile , respectively . Conclusion : The findings indicate that study design and methods are adequate for the upcoming prospect i ve analyses of aetiology and consequences of burnout and of the impact of workplace interventions OBJECTIVES To test the premise that individually tailored psychosocial , nursing and medical interventions to nursing home residents with dementia will reduce the frequency and severity of behavioural symptoms . METHODS A four-member team comprising a psychiatrist , psychologist and nurses conducted detailed assessment s of 99 nursing home residents with advanced dementia who were rated by staff as having frequent , severe behavioural disturbances . Residents were then r and omly assigned to an ' early ' or ' late ' intervention group and observed for four weeks . Interventions encompassed psychosocial strategies , nursing approaches , psychotropic medications and management of pain . Outcome measures included the frequency and severity of disruptive behaviours and assessment s of change by senior nursing home staff . RESULTS While improvements in behaviour were noted in both groups from the outset of observations , pointing to a powerful Hawthorne effect , consultancies were associated with a modest but statistically significant decrease in challenging behaviours . Staff assessment s of the interventions were highly favourable . CONCLUSIONS The consultancies were effective and well received by staff . The change-inducing nature of any new endeavour is an integral part of research in a long-term setting Nurses who provide care for individuals with Alzheimer 's disease and other dementias are at risk of burnout . Self-efficacy is a psychological construct with the potential to help reduce or prevent the impact of caregiver stress . Evidence supporting a link between higher levels of self-efficacy and lower levels of stress is emerging among lay caregivers . However , concurrent research for professional caregivers lags behind , partly due to a lack of appropriate self-efficacy measures for this population . We developed an intervention to enhance self-efficacy  and an inventory to measure its improvements among long-term care nurses . Training result ed in lasting improvements in knowledge and selfefficacy regarding the management of challenging team , resident , and family situations . Short-term reductions in caregiver burnout were also evident . Suggestions for maintaining improvements in caregiver burnout over longer periods are offered Study Design . R and omized controlled trial . Objective . To evaluate the effectiveness of an ergonomic and psychosocial intervention in reducing  low back pain ( LBP ) among health care workers . Summary of Background Data . LBP and injuries are reported frequently among health care workers worldwide . Improvement of person-transfer techniques is the preferred tool in the prevention of both . Although popular , to our knowledge , any effect has not been documented in controlled trials . Methods . Study participants were eldercare workers from 19 eldercare groups r and omly assigned to the transfer technique , stress management , or reference arm . A total of 163 individuals ( 79 % of the source population ) participated in both baseline and follow-up after 2 years . Outcome was intra-individual change in rating of LBP during the past 3 and 12 months . Results . We found no difference in LBP in any of the intervention arms over the study period . Conclusion . The study showed no effect of a transfer technique or stress management program targeting LBP . Thus , there is a need for discussing other priorities in the prevention of LBP among health care workers This study was design ed to investigate the impact of staff education on the behaviour and quality of life of residents with dementia and on staff members ’ attitudes about working with people with dementia and level of burnout .  Staff from three aged care facilities participated in the study ( n = 52 ) . These facilities were r and omly assigned to one of two intervention groups or a control group . Staff assigned to the intervention groups received an eight-week behaviourally-based programme . Staff from one aged care facility also participated in a peer support group design ed to reinforce educational material and facilitate positive changes among staff members . Behavioural symptoms displayed by residents ( n = 76 ) in each of the facilities were also assessed . Assessment s were conducted at pre-intervention , post-intervention , three- and six-month follow-up . The results of this study indicated that education or peer support was not associated with an improvement in resident behaviour or quality of life . Education or peer support also did not impact on staff members ’ level of burn 
    Output:
    
CONCLUSION Work-directed and combined interventions are able to achieve beneficial longer-term effects on staff burnout .
Person-directed interventions achieve short-term results in reducing staff burnout .