human
***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: This report evaluates whether a program for older volunteers  , design ed for both benerativity and health promotion , leads to short-term improvements inmultiple behavioral risk factors and positive effects on intermediary risk factors for disability and other morbidities . The Experience Corps ® places  older volunteers  in public elementary schools in roles design ed to meet schools ’ needs and increase the social , physical , and cognitive activity of the volunteers . This article reports on a pilot r and omized trial in Baltimore , Maryl and . The 128 volunteers were 60–86 years old ; 95 % were African American . At follow-up of 4–8 months , physical activity , strength , people one could turn to for help , and cognitive activity increased significantly , and walking speed decreased significantly less , in participants compared to controls . In this pilot trial , physical , cognitive , and social activity increased , suggesting the potential for the Experience Corps to improve health for an aging population and simultaneously improve educational outcomes for children Family caregivers , the “ second victims ” or hidden patients in dementia care , are at risk for social isolation , stress , depression , and mortality . Telephone-based support ( telesupport groups ) represents a practical , low-burden , low-cost source of emotional support . The present study evaluated the feasibility and effectiveness of professionally led telephone-based support groups for female family caregivers of community-dwelling dementia patients . Recruited through various community sources , 103 female caregivers were r and omized to the telesupport group treatment or a control condition . Effects on caregiver burden , depression , and personal gains were evaluated at 6 months , the main end point . Older care-givers ( ≥65 ) in telesupport  reported lower depression than control group caregivers did AIM This paper is a report of a study to explore the effects of psychosocial group nursing intervention on older people 's feelings of loneliness , social activity and psychological well-being . BACKGROUND Older people 's loneliness is associated with low quality of life , and impaired health , increased use of health and social services and increased mortality . Previous intervention studies have achieved quite modest results . METHOD A r and omized controlled trial was conducted between 2003 and 2006 using a group intervention aim ed at empowering older people , and promoting peer support and social integration .  A total of 235 people ( > 74 years ) suffering from loneliness met 12 times with professional leaders in groups . The UCLA Loneliness Scale and Lubben 's Social Network Scale were used at entry , after 3 and 6 months . Psychological well-being was charted using a six-dimensional question naire at baseline and 12 months later . FINDINGS A statistically significantly larger proportion of intervention group participants had found new friends during the follow-up year ( 45 % vs. 32 % , P = 0.048 ) , and 40 % of intervention group participants continued their group meetings for 1 year . However , no differences were found in loneliness or social networks between the groups . Psychological well-being score improved statistically significantly in the intervention groups [ + 0.11 , 95 % confidence interval ( CI ) : + 0.04 to + 0.13 ] , compared with the controls ( + 0.01 , 95 % CI : -0.05 to + 0.07 , P = 0.045 ) . Feeling needed was statistically significantly more common in the intervention groups ( 66 % ) than in controls ( 49 % , P = 0.019 ) . CONCLUSION New sensitive measurements of loneliness and social isolation are needed to measure fluctuations in feelings of loneliness and in social isolation This study focused on the assessment of depression among nursing home elders , and on determining the efficacy of an intervention strategy for depression using a geropsychiatric nurse in conjunction with trained  older adult volunteers  in the role of mental health paraprofessionals .  Nursing home residents ( n = 139 ) were assessed for depression using the Geriatric Depression Scale ( GDS ) ; 94 ( 68 % ) were found to have depressive symptomatology . Among those receiving the intervention , depressive symptomatology was significantly reduced , but no significant decline was evident in the control group . The ability of the minimum data set ( MDS ) to detect depression as compared to the GDS was evaluated . Relationships between depression and health status , life satisfaction , and social support were also examined The aim of the paper is to critically review the notion of  social capital  and review empirical literature on the association between social capital and health across countries . The methodology used for the review includes a systematic search on electronic data bases for peer- review ed published literature . We categorize studies according to level of analysis ( single and multilevel ) and examine whether studies reveal a significant health impact of individual and area level social capital . We compare the study conclusions according to the country 's degrees of economic egalitarianism . Regardless of study design , our findings indicate that a positive association ( fixed effect ) exists between social capital and better health irrespective of countries degree of egalitarianism . However , we find that the between-area variance ( r and om effect ) in health tends to be lower in more egalitarian countries than in less egalitarian countries . Our tentative conclusion is that an association between social capital and health at the individual level is robust with respect to the degree of egalitarianism within a country . Area level or context ual social capital may be less salient in egalitarian countries in explaining health differences across places Background Interventions relieving the burden of caregiving may postpone or prevent patient institutionalization . The objective of this study was to determine whether a family meetings intervention was superior to usual care in postponing nursing home placement of patients with dementia . Methods A r and omized multicenter trial was conducted among 192 patients with a clinical diagnosis of dementia living at home at enrolment and their primary family caregiver . Dyads of caregivers and patients were r and omized to the  family meetings intervention  ( n = 96 ) or  usual care ( n = 96 ) condition . The intervention consisted of two individual sessions with the primary caregiver and four family counseling sessions that included family members and friends . The primary outcome measure was the time until institutionalization of the patient . Intention-to-treat as well as per protocol analyses were performed . Survival analyses were carried out to evaluate the effectiveness of the intervention . Results During 18 months follow-up 23 of 96 relatives with dementia of caregivers in the intervention group and 18 of 96 relatives with dementia of caregivers in the usual care group were institutionalized . No significant difference between the intervention and the usual care group was found in time until institutionalization ( adjusted hazard ratio ( HR ) 1.46 , 95 % confidence interval ( CI ) 0.78 to 2.74 ) . The per- protocol analysis revealed no significant effect either ( adjusted HR 0.57 , 95 % CI 0.21 to 1.57 ) , although the number of placements among the adherers was relatively low ( 9.4 % ) . A subgroup effect was found for patients ’ age , with a significantly higher risk of institutionalization for ‘ younger ’ patients in the intervention group compared with the usual care group ( adjusted HR = 4.94 , 95 % CI 1.10 to 22.13 ) . Conclusion This family meetings intervention for primary caregivers of patients with dementia did not postpone patient institutionalization more than usual care . Trial Registration : Controlled-Trials.com IS RCT PURPOSE Aging , in conjunction with decreasing physical activity , is associated with a range of health problems . Simple , low-maintenance , population -based means of promoting activity to counteract the age-associated decline are required . We therefore assessed the effect of pedometry and buddy support to increase physical activity . METHODS We undertook a clustered r and omized trial ( HKCTR-346 ) of 24 community centers involving 399 older Chinese participants ( ≥ 60 yr ) . Centers were r and omly allocated to 1 ) pedometry and buddy , 2 ) pedometry and no buddy , 3 ) no pedometry and buddy , and 4 ) no pedometry and no buddy with a 2 × 2 factorial design . The trial simultaneously tested the individual and combined effects of the interventions . The intervention groups also received monthly organized group activities to provide encouragement and support . Outcome measures were assessed at 6 and 12 months , including physical fitness and activity and cardiovascular disease risk factors ( anthropometry and blood pressure ) . RESULTS From the 24 centers , 356 volunteers ( 89.2 % ) completed the study . Those receiving the interventions had higher mean physical activity levels at 12 months of 1820 ( 95 % confidence interval ( CI ) = 1360 - 2290 ) and 1260 ( 95 % CI = 780 - 1740 ) MET·min·wk(-1 ) , respectively relative to the decrease in the control groups . The buddy peer support intervention  significantly improved mean aerobic fitness ( 12 % [ 95 % CI = 4%-21 % ] ) and reduced both body fat ( -0.6 % [ 95 % CI = -1.1 % to 0.0 % ] ) and time to complete the 2.5-m get-up- and -go test ( -0.27 [ 95 % CI = -0.53 to -0.01 ] s ) . No other improvements in the cardiovascular disease risk factors were observed . The combination of motivational tools was no better than the individual interventions . CONCLUSIONS Both motivational interventions increased physical activity levels , and the buddy style improved fitness . These tools could be useful adjuncts in the prevention of obesity and age-related complications Objective : To determine the effectiveness of a counseling and support intervention for spouse caregivers in delaying time to nursing home placement of patients with Alzheimer disease ( AD ) , and identify the mechanisms through which the intervention accomplished this goal . Methods : We conducted a r and omized controlled trial of an enhanced counseling and support intervention compared to usual care . Participants were a referred volunteer sample of 406 spouse caregivers of community-dwelling patients who had enrolled in the study over a 9.5-year period . The intervention consisted of six sessions of individual and family counseling , support group participation , and continuous availability of ad hoc telephone counseling . Structured question naires were administered at baseline and at regular follow-up intervals , every 4 months for the first year and every 6 months thereafter . Cox proportional hazard models were used to test the effects of the intervention on the time to nursing home placement for the patients after controlling for multiple time-invariant and time-dependent predictors of placement . Results : Patients whose spouses received the intervention experienced a 28.3 % reduction in the rate of nursing home placement compared with usual care controls ( hazard ratio = 0.717 after covariate adjustment , p = 0.025 ) . The difference in model-predicted median time to placement was 557 days . Improvements in caregivers ’ satisfaction with social support , response to patient behavior problems , and symptoms of depression collectively accounted for 61.2 % of the intervention ’s beneficial impact on placement . Conclusion : Greater access to effective programs of counseling and support could yield considerable benefits for caregivers , patients with Alzheimer disease , and society OBJECTIVES To investigate the effect of self-management group rehabilitation for persons with dementia ( PwD ) and their spouses on their health-related quality of life ( HRQoL ) , the cognition of the PwD , and the costs of health and social services . DESIGN A r and omized controlled trial . SETTING Primary care and memory clinics in the Helsinki metropolitan area , Finl and . PARTICIPANTS PwD ( N = 136 ) and their spouses ( N = 136 ) . INTERVENTION Couples were r and omized to usual care or eight-session self-management groups for PwD and concurrently for their spouses . Sessions aim to enhance self-efficacy and problem-solving skills and to provide peer support . MEASUREMENTS The primary outcome measures were the HRQoL of PwD ( measured using a generic , comprehensive ( 15-dimensional ) , self-administered instrument ( 15D ) ) and spouses ( measured using the R AND -36 ) and the spousal Sense of Competence Question naire ( SCQ ) . Secondary outcome measures were PwD cognition ( Verbal Fluency ( VF ) , Clock Drawing Test ( CDT ) ) and costs of health and social services during 24 months . RESULTS At 3 months , the spouse physical component of the R AND -36 improved ( mean change 1.0 , 95 % confidence interval ( CI ) = -0.5 to 2.4 ) for those undergoing the intervention and worsened for controls ( mean change -2.0 , 95 % CI = -3.5 to -0.4 ) ( P = .006 adjusted for age , sex , baseline value of the physical component of the R AND -36 ) . There were no differences between the groups on the mental component of the R AND -36 , the SCQ , or the 15D . At 9 months , PwD change in VF was -0.38 ( 95 % CI = -1.03 to 0.27 ) in intervention group and -1.60 ( 95 % CI = -2.26 to -0.94 ) for controls ( P = .011 adjusted for age , sex , baseline MMSE score ) . CDT changes were similar to VF changes . Differences in incremental costs between the groups was -436 € per person per year ( 95 % CI = -4,986 to 4,115 ) for PwD ( P = .35 adjusted for age , CDR ) and -896 € per person per year ( 95 % CI = -3,657 to 1,864 ) for spouses ( P = .51 adjusted for Pw 
    Output:
    
agent
According to sufficiently reported outcomes , social capital interventions showed mixed effects on quality of life , well-being and self-perceived health and were generally ineffective on loneliness , mood and mortality .
Conclusions Our review highlights the lack of evidence and the diversity among trials , while supporting the potential of social capital interventions to reach comprehensive health effects in older adults
***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: This report evaluates whether a program for older volunteers  , design ed for both benerativity and health promotion , leads to short-term improvements inmultiple behavioral risk factors and positive effects on intermediary risk factors for disability and other morbidities . The Experience Corps ® places  older volunteers  in public elementary schools in roles design ed to meet schools ’ needs and increase the social , physical , and cognitive activity of the volunteers . This article reports on a pilot r and omized trial in Baltimore , Maryl and . The 128 volunteers were 60–86 years old ; 95 % were African American . At follow-up of 4–8 months , physical activity , strength , people one could turn to for help , and cognitive activity increased significantly , and walking speed decreased significantly less , in participants compared to controls . In this pilot trial , physical , cognitive , and social activity increased , suggesting the potential for the Experience Corps to improve health for an aging population and simultaneously improve educational outcomes for children Family caregivers , the “ second victims ” or hidden patients in dementia care , are at risk for social isolation , stress , depression , and mortality . Telephone-based support ( telesupport groups ) represents a practical , low-burden , low-cost source of emotional support . The present study evaluated the feasibility and effectiveness of professionally led telephone-based support groups for female family caregivers of community-dwelling dementia patients . Recruited through various community sources , 103 female caregivers were r and omized to the telesupport group treatment or a control condition . Effects on caregiver burden , depression , and personal gains were evaluated at 6 months , the main end point . Older care-givers ( ≥65 ) in telesupport  reported lower depression than control group caregivers did AIM This paper is a report of a study to explore the effects of psychosocial group nursing intervention on older people 's feelings of loneliness , social activity and psychological well-being . BACKGROUND Older people 's loneliness is associated with low quality of life , and impaired health , increased use of health and social services and increased mortality . Previous intervention studies have achieved quite modest results . METHOD A r and omized controlled trial was conducted between 2003 and 2006 using a group intervention aim ed at empowering older people , and promoting peer support and social integration .  A total of 235 people ( > 74 years ) suffering from loneliness met 12 times with professional leaders in groups . The UCLA Loneliness Scale and Lubben 's Social Network Scale were used at entry , after 3 and 6 months . Psychological well-being was charted using a six-dimensional question naire at baseline and 12 months later . FINDINGS A statistically significantly larger proportion of intervention group participants had found new friends during the follow-up year ( 45 % vs. 32 % , P = 0.048 ) , and 40 % of intervention group participants continued their group meetings for 1 year . However , no differences were found in loneliness or social networks between the groups . Psychological well-being score improved statistically significantly in the intervention groups [ + 0.11 , 95 % confidence interval ( CI ) : + 0.04 to + 0.13 ] , compared with the controls ( + 0.01 , 95 % CI : -0.05 to + 0.07 , P = 0.045 ) . Feeling needed was statistically significantly more common in the intervention groups ( 66 % ) than in controls ( 49 % , P = 0.019 ) . CONCLUSION New sensitive measurements of loneliness and social isolation are needed to measure fluctuations in feelings of loneliness and in social isolation This study focused on the assessment of depression among nursing home elders , and on determining the efficacy of an intervention strategy for depression using a geropsychiatric nurse in conjunction with trained  older adult volunteers  in the role of mental health paraprofessionals .  Nursing home residents ( n = 139 ) were assessed for depression using the Geriatric Depression Scale ( GDS ) ; 94 ( 68 % ) were found to have depressive symptomatology . Among those receiving the intervention , depressive symptomatology was significantly reduced , but no significant decline was evident in the control group . The ability of the minimum data set ( MDS ) to detect depression as compared to the GDS was evaluated . Relationships between depression and health status , life satisfaction , and social support were also examined The aim of the paper is to critically review the notion of  social capital  and review empirical literature on the association between social capital and health across countries . The methodology used for the review includes a systematic search on electronic data bases for peer- review ed published literature . We categorize studies according to level of analysis ( single and multilevel ) and examine whether studies reveal a significant health impact of individual and area level social capital . We compare the study conclusions according to the country 's degrees of economic egalitarianism . Regardless of study design , our findings indicate that a positive association ( fixed effect ) exists between social capital and better health irrespective of countries degree of egalitarianism . However , we find that the between-area variance ( r and om effect ) in health tends to be lower in more egalitarian countries than in less egalitarian countries . Our tentative conclusion is that an association between social capital and health at the individual level is robust with respect to the degree of egalitarianism within a country . Area level or context ual social capital may be less salient in egalitarian countries in explaining health differences across places Background Interventions relieving the burden of caregiving may postpone or prevent patient institutionalization . The objective of this study was to determine whether a family meetings intervention was superior to usual care in postponing nursing home placement of patients with dementia . Methods A r and omized multicenter trial was conducted among 192 patients with a clinical diagnosis of dementia living at home at enrolment and their primary family caregiver . Dyads of caregivers and patients were r and omized to the  family meetings intervention  ( n = 96 ) or  usual care ( n = 96 ) condition . The intervention consisted of two individual sessions with the primary caregiver and four family counseling sessions that included family members and friends . The primary outcome measure was the time until institutionalization of the patient . Intention-to-treat as well as per protocol analyses were performed . Survival analyses were carried out to evaluate the effectiveness of the intervention . Results During 18 months follow-up 23 of 96 relatives with dementia of caregivers in the intervention group and 18 of 96 relatives with dementia of caregivers in the usual care group were institutionalized . No significant difference between the intervention and the usual care group was found in time until institutionalization ( adjusted hazard ratio ( HR ) 1.46 , 95 % confidence interval ( CI ) 0.78 to 2.74 ) . The per- protocol analysis revealed no significant effect either ( adjusted HR 0.57 , 95 % CI 0.21 to 1.57 ) , although the number of placements among the adherers was relatively low ( 9.4 % ) . A subgroup effect was found for patients ’ age , with a significantly higher risk of institutionalization for ‘ younger ’ patients in the intervention group compared with the usual care group ( adjusted HR = 4.94 , 95 % CI 1.10 to 22.13 ) . Conclusion This family meetings intervention for primary caregivers of patients with dementia did not postpone patient institutionalization more than usual care . Trial Registration : Controlled-Trials.com IS RCT PURPOSE Aging , in conjunction with decreasing physical activity , is associated with a range of health problems . Simple , low-maintenance , population -based means of promoting activity to counteract the age-associated decline are required . We therefore assessed the effect of pedometry and buddy support to increase physical activity . METHODS We undertook a clustered r and omized trial ( HKCTR-346 ) of 24 community centers involving 399 older Chinese participants ( ≥ 60 yr ) . Centers were r and omly allocated to 1 ) pedometry and buddy , 2 ) pedometry and no buddy , 3 ) no pedometry and buddy , and 4 ) no pedometry and no buddy with a 2 × 2 factorial design . The trial simultaneously tested the individual and combined effects of the interventions . The intervention groups also received monthly organized group activities to provide encouragement and support . Outcome measures were assessed at 6 and 12 months , including physical fitness and activity and cardiovascular disease risk factors ( anthropometry and blood pressure ) . RESULTS From the 24 centers , 356 volunteers ( 89.2 % ) completed the study . Those receiving the interventions had higher mean physical activity levels at 12 months of 1820 ( 95 % confidence interval ( CI ) = 1360 - 2290 ) and 1260 ( 95 % CI = 780 - 1740 ) MET·min·wk(-1 ) , respectively relative to the decrease in the control groups . The buddy peer support intervention  significantly improved mean aerobic fitness ( 12 % [ 95 % CI = 4%-21 % ] ) and reduced both body fat ( -0.6 % [ 95 % CI = -1.1 % to 0.0 % ] ) and time to complete the 2.5-m get-up- and -go test ( -0.27 [ 95 % CI = -0.53 to -0.01 ] s ) . No other improvements in the cardiovascular disease risk factors were observed . The combination of motivational tools was no better than the individual interventions . CONCLUSIONS Both motivational interventions increased physical activity levels , and the buddy style improved fitness . These tools could be useful adjuncts in the prevention of obesity and age-related complications Objective : To determine the effectiveness of a counseling and support intervention for spouse caregivers in delaying time to nursing home placement of patients with Alzheimer disease ( AD ) , and identify the mechanisms through which the intervention accomplished this goal . Methods : We conducted a r and omized controlled trial of an enhanced counseling and support intervention compared to usual care . Participants were a referred volunteer sample of 406 spouse caregivers of community-dwelling patients who had enrolled in the study over a 9.5-year period . The intervention consisted of six sessions of individual and family counseling , support group participation , and continuous availability of ad hoc telephone counseling . Structured question naires were administered at baseline and at regular follow-up intervals , every 4 months for the first year and every 6 months thereafter . Cox proportional hazard models were used to test the effects of the intervention on the time to nursing home placement for the patients after controlling for multiple time-invariant and time-dependent predictors of placement . Results : Patients whose spouses received the intervention experienced a 28.3 % reduction in the rate of nursing home placement compared with usual care controls ( hazard ratio = 0.717 after covariate adjustment , p = 0.025 ) . The difference in model-predicted median time to placement was 557 days . Improvements in caregivers ’ satisfaction with social support , response to patient behavior problems , and symptoms of depression collectively accounted for 61.2 % of the intervention ’s beneficial impact on placement . Conclusion : Greater access to effective programs of counseling and support could yield considerable benefits for caregivers , patients with Alzheimer disease , and society OBJECTIVES To investigate the effect of self-management group rehabilitation for persons with dementia ( PwD ) and their spouses on their health-related quality of life ( HRQoL ) , the cognition of the PwD , and the costs of health and social services . DESIGN A r and omized controlled trial . SETTING Primary care and memory clinics in the Helsinki metropolitan area , Finl and . PARTICIPANTS PwD ( N = 136 ) and their spouses ( N = 136 ) . INTERVENTION Couples were r and omized to usual care or eight-session self-management groups for PwD and concurrently for their spouses . Sessions aim to enhance self-efficacy and problem-solving skills and to provide peer support . MEASUREMENTS The primary outcome measures were the HRQoL of PwD ( measured using a generic , comprehensive ( 15-dimensional ) , self-administered instrument ( 15D ) ) and spouses ( measured using the R AND -36 ) and the spousal Sense of Competence Question naire ( SCQ ) . Secondary outcome measures were PwD cognition ( Verbal Fluency ( VF ) , Clock Drawing Test ( CDT ) ) and costs of health and social services during 24 months . RESULTS At 3 months , the spouse physical component of the R AND -36 improved ( mean change 1.0 , 95 % confidence interval ( CI ) = -0.5 to 2.4 ) for those undergoing the intervention and worsened for controls ( mean change -2.0 , 95 % CI = -3.5 to -0.4 ) ( P = .006 adjusted for age , sex , baseline value of the physical component of the R AND -36 ) . There were no differences between the groups on the mental component of the R AND -36 , the SCQ , or the 15D . At 9 months , PwD change in VF was -0.38 ( 95 % CI = -1.03 to 0.27 ) in intervention group and -1.60 ( 95 % CI = -2.26 to -0.94 ) for controls ( P = .011 adjusted for age , sex , baseline MMSE score ) . CDT changes were similar to VF changes . Differences in incremental costs between the groups was -436 € per person per year ( 95 % CI = -4,986 to 4,115 ) for PwD ( P = .35 adjusted for age , CDR ) and -896 € per person per year ( 95 % CI = -3,657 to 1,864 ) for spouses ( P = .51 adjusted for Pw 
    Output:
    