***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: As the population of older Latinos in the U.S. increases , availability of culturally adapted geriatric psychiatry services is becoming a growing concern . This issue is exacerbated for rural Latino population s. In this study , we assessed whether neurocognitive assessment  via telepsychiatry ( TP ) using a Spanish- language battery would be comparable to in-person ( IP ) testing using the same battery in a sample of Spanish-speaking older adults in a rural setting . Patients ( N = 22 ) received IP and TP testing 2 weeks apart . The order of IP and TP test administrations in individual subjects was determined r and omly . Comparison of scores indicated that there were no significant differences between IP and TP test performance though both groups scored non-significantly higher at the second visit . This study demonstrates feasibility and utility of neurocognitive testing in Spanish using TP among older rural Latinos Background It is possible that cross-over studies included in current systematic review s are being inadequately assessed , because the current risk of bias tools do not consider possible biases specific to cross-over design . We performed this study to evaluate whether this was being done in  cross-over studies included in Cochrane  Systematic Review s ( CSRs ) . Methods We search ed the Cochrane Library ( up to 2013 issue 5 ) for CSRs that included at least one cross-over trial . Two authors independently undertook the study selection and data extraction . A r and om sample of the CSRs was selected and we evaluated whether the cross-over trials in these CSRs were assessed according to criteria suggested by the Cochrane h and book . In addition we reassessed the risk of bias of these cross-over trials by a checklist developed form the Cochrane h and book . Results We identified 688 CSRs that included one or more cross-over studies . We chose a r and om sample of 60 CSRs and these included 139 cross-over studies . None of these CSRs undertook a risk of bias assessment specific for cross-over studies . In fact items specific for cross-over studies were seldom considered anywhere in quality assessment of these CSRs . When we reassessed the risk of bias , including the 3 items specific to cross-over trials , of these 139 studies , a low risk of bias was judged for appropriate cross-over design in 110(79 % ) , carry-over effects in 48(34 % ) and for reporting data in all stages of the trial in 114(82 % ) . Assessment of biases in cross-over trials could affect the GRADE assessment of a review ’s findings . Conclusion The current Cochrane risk of bias tool is not adequate to assess cross-over studies . Items specific to cross-over trials leading to potential risk of bias are generally neglected in CSRs . A proposed check list for the evaluation of cross-over trials is provided Accurate underst and ing of practice characteristics , performance stability , and error on neuropsychological tests is essential to both valid clinical assessment and maximization of signal detection for clinical trials of cognitive enhancing drugs . We examined practice effects in 28 healthy adults . As part of a larger study using donepezil and simulating a Phase I trial , participants were r and omized into : placebo , no-treatment and donepezil . Donepezil results are presented elsewhere . Neuropsychological tests were administered in a fixed order for 6 weeks , with alternate forms available for most tests . Despite alternate forms , ANOVAs revealed significant improvements for the pooled control group ( placebo and no-treatment ) on all tests except Letter Number Sequencing and Trails B. Learning occurred principally in the first three to four sessions . PASAT and Stroop interference showed the greatest learning . Thus , serial assessment with alternate forms may attenuate retest effects on some tests , but continued learning occurs on novel tests or those in which an advantageous test-taking strategy can be identified . Alternate forms and baseline practice sessions may help control early , rapid improvements in clinical trials Objectives : To compare in-person versus telehealth ( TH ) assessment of discourse ability in adults with chronic traumatic brain injury ( TBI ) . Design : Repeated- measures design with r and om order of conditions . Participants : Twenty adults with moderate-to-severe TBI . Method : Participants completed conversation , picture description , story-generation , and procedural description tasks . Sessions were video-recorded and transcribed . Measures : Measures of productivity and quality of discourse . Results : Significant differences between conditions were not detected in this sample , and feedback from participants was positive . Conclusions : These preliminary results support the use of TH for the assessment of discourse ability in adults with TBI , at least for individuals with sufficient cognitive skills to follow TH procedures OBJECTIVE Combat veterans returning to society with impairing mental health conditions such as PTSD and major depression ( MD ) report significant barriers to care related to aspects of traditional psychotherapy service delivery ( e.g. , stigma , travel time , and cost ) . Hence , alternate treatment delivery methods are needed . Home-based telehealth ( HBT ) is one such option ; however , this delivery mode has not been compared to in person , clinic-based care for PTSD in adequately powered trials . The present study was design ed to compare relative noninferiority of evidence -based psychotherapies for PTSD and MD , specifically Behavioral Activation  and  Therapeutic Exposure  ( BA-TE ) , when delivered via HBT versus in person , in clinic delivery . METHOD A repeated measures ( i.e. , baseline , posttreatment , 3- , 6-month follow-up ) r and omized controlled design powered for noninferiority analyses was used to compare PTSD and MD symptom improvement in response to BA-TE delivered via HBT versus in person , in clinic conditions . Participants were 232 veterans diagnosed with full criteria or predefined subthreshold PTSD . RESULTS PTSD and MD symptom improvement following BA-TE delivered by HBT was comparable to that of BA-TE delivered in person at posttreatment and at 3- and 12-month follow-up . CONCLUSION Evidence -based psychotherapy for PTSD and depression can be safely and effectively delivered via HBT with clinical outcomes paralleling those of clinic-based care delivered in person . HBT , thereby , addresses barriers to care related to both logistics and stigma OBJECTIVE This study aims to assess the current utilisation of a  real-time teleophthalmology service for rural Western Australia ( WA ) . DESIGN Service evaluation by prospect i ve audit . SETTING Includes general practice s , optometrists , hospitals in rural WA and the Lions Eye Institute in Perth . PARTICIPANTS Eighty-five patients from rural WA participating . INTERVENTIONS Video consultation ( VC ) with a general ophthalmologist . MAIN OUTCOME MEASURES Number of referring practitioners and their locations , software and imaging equipment used as well as the presentation , working diagnosis and follow-up plan for each consultation . RESULTS Eighty-five participants took part in a total of 100 VCs  in the 5-month data collection period . There were 49 men ( 58 % ) ; age range 7 - 92 years ; 31 identified as Indigenous Australian ( 37 % ) . Participants were referred by optometrists ( 59 % ) , hospital district medical officers ( 23 % ) and GPs ( 18 % ) . Karratha ( 41 % ) , Albany ( 20 % ) and Broome ( 14 % ) were the main VC locations . There were 31 different eye conditions managed ; red eye , acute vision loss , known glaucoma and abnormal retinal photographs were the main presentations . Skype was the commonly used software ( 71 % ) . Images were provided in 63 % of all VCs . The main equipment used included digital retinal cameras ( 56 % ) , smartphones ( 25 % ) and digital slit lamps ( 13 % ) . An outpatient appointment with the ophthalmologist was recommended following 35 VCs . CONCLUSIONS Optometrists used this service most frequently , despite a lack of financial incentive . Digital retinal cameras and smartphones were the most commonly used imaging modalities . Overall , real-time teleophthalmology was used in the management of a broad range of eye conditions and was a useful supplement to outreach ophthalmology services BACKGROUND Dementia is a common but frequently undiagnosed problem in aging . Barriers to early diagnosis include a lack of routine screening for dementia and a lack of access to specialty consultative services . We conducted a pilot study to see if telemedicine could provide reliable , accurate geriatric consultative services to evaluate patients for dementia who were residing at remote sites . METHODS This was a prospect i ve cohort study that compared the diagnostic reliability of telemedicine to an in-person examination for dementia . Eligible subjects were residents of a Washington State Veterans ' Home , age 60 years or older , with no prior diagnosis of dementia . Eligible subjects were screened for dementia using the 7-Minute Screen . Veterans who screened positive and consented to participate in the study received an in-person neuropsychiatric evaluation at baseline , and then both telemedicine and in-person examinations for dementia conducted by experienced geriatric psychiatrists . The accuracy of the telemedicine diagnosis was estimated by comparing it to the diagnosis from the clinical examination . Three geriatric psychiatrists who were blinded to the results of the clinical examination conducted the telemedicine and in-person examinations . We also assessed attitudes of the subjects and geriatric psychiatrists towards the telemedicine sessions . RESULTS Eighteen of 85 subjects screened were ' positive ' for dementia on the 7 Minute Screen . Of these , 16 consented to participate in the telemedicine study . Twelve of the 16 subjects were subsequently diagnosed with dementia by the telemedicine examination . The telemedicine diagnoses were in 100 % agreement with the diagnoses from the in-person clinical examinations . Moreover , the subjects reported a high degree of satisfaction with the telemedicine experience and that they would like to have further care through telemedicine in the future . The geriatric psychiatrists reported technical difficulties with the audio-visual quality of telemedicine in the initial phases of the project that resolved as familiarity with the telemedicine equipment increased . None of these problems had an adverse impact on the diagnostic accuracy of telemedicine . CONCLUSIONS We found that telemedicine was as accurate as an in-person clinical examination in establishing the diagnosis of dementia . In addition , subjects reported a high degree of satisfaction with telemedicine and a willingness to participate in telemedicine clinical care in the future . Given the large increase in the aging population and the shortage of geriatric psychiatrists nationally , it appears that telemedicine may be a promising means to exp and the availability of geriatric psychiatric consultation to remote areas BACKGROUND Recent advances in telehealth have improved access to health care for those in rural areas . It is important that examinations conducted via telehealth are comparable to in-person testing . A rural and remote memory clinic in Saskatoon provided an opportunity to compare scores on the  Mini-Mental State Examination ( MMSE ) administered in-person and via telehealth . METHODS After an initial one day assessment in Saskatoon , patients were seen in follow-up at 6 and 12 weeks . Individual patients were r and omly assigned to either in-person follow-up assessment in Saskatoon or telehealth assessment in their home community . Patients who initially received in-person assessment s were seen by telehealth for their next follow-up visit and vice-versa . The same neurologist administered MMSEs at all visits . The first 71 patients with both 6 and 12 week follow-up assessment s were included in this study . The scores of in-person and  telehealth MMSE administrations were compared using the methods of Bl and and Altman as well as a paired t-test . RESULTS MMSE scores did not differ significantly between telehealth ( 22.34 + /- 6.35 ) and in-person ( 22.70 + /- 6.51 ) assessment s. CONCLUSION Telehealth provides an acceptable means of assessing mental status of patients in remote areas Mini-Mental State Examination scores were compared in an adult psychiatric population when the test was performed face to face and over a Low-Cost VideoConferencing System ( LCVC ) . The minor changes to the instrument that are required to make it compatible with the LCVC are described . The high correlations achieved between the test scores in the two conditions suggests that this cognitive screening test may be reliably performed in this group of patients over the LCVC 
    Output:
    
Test specific analyses indicated that verbally-mediated tasks including digit span , verbal fluency , and list learning were not affected by videoconference administration .