***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: A method for assessing affect states among older people with Alzheimer 's disease was developed for use in a study design ed to evaluate a special care unit for such residents of a nursing home . The 6-item  Philadelphia Geriatric Center Affect Rating Scale was design ed for the use of research and other staff in assessing positive affect ( pleasure , interest , contentment ) and negative affect ( sadness , worry/anxiety , and anger ) by direct observation of facial expression , body movement , and other cues that do not depend on self-report , among 253 demented and 43 nondemented residents . Each affect scale was highly reliable , expressed in estimated portions of a 10-minute observation period when the affect expression occurred . Validity estimates were affirmative in showing discriminant correlations between the positive states and various independent measures of social and other outwardly engaged behavior and between negative states and other measures of depression , anger , anxiety , and withdrawal . Limited support for the two-factor dimensionality of the affect ratings was obtained , although positive and negative affect were correlated , rather than independent . Some hope is offered that the preference and aversions of Alzheimer patients may be better understood by observations of their emotional behaviors and that such methods may lead to a better ability to judge institutional quality 1 . High stress is one of the possible causes of agitation behaviors in persons with dementia ; use of stress management interventions may be helpful in reducing the stress level . 2 . Two nursing interventions , h and massage and therapeutic touch , were effective in producing a relaxation response in persons with dementia who had a history of agitation behaviors ; they did not , however , decrease agitation behavior . 3 . H and massage was more effective in producing relaxation than was therapeutic touch 
    Output:
    
The views and experiences of the garden are discussed in relation to themes of how the garden was used , nature of interactions , impact/effect of the gardens , mechanisms/how the garden was thought to have an effect , and negatives ( such as perception of the garden as a hazard and the limited staff time ) .
There are promising impacts on levels of agitation in care home residents with dementia who spend time in a garden .