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: OBJECTIVES Acupressure , a complementary and alternative medicine ( CAM ) treatment , uses fingertips , rather than needles , to stimulate acupoints on the skin and has been implicated as a successful treatment for a variety of medical disorders . However , acupressure 's underlying mechanisms remain unclear . One theory is that acupoint stimulation modulates autonomic nervous system activity . Previous studies have suggested that acupressure may positively affect heart rate and blood pressure . The current study investigated the effects of a type of acupressure , Jin Shin , on cardiovascular function in stroke survivors , a population that could especially benefit from a treatment promoting cardiovascular health . The study tested the hypothesis that active acupressure treatments would reduce heart rate and blood pressure ( i.e. , induce a greater relaxation response ) above and beyond that seen during placebo acupressure treatments . METHODS A r and omised , placebo-controlled , single-blind crossover design was utilised , in which 16 participants received 8 weeks of either active or placebo acupressure  followed by washout and crossover into the opposite treatment condition . Heart rate and blood pressure measurements were taken throughout treatments . RESULTS Active acupressure treatments were associated with a significantly greater ( p=.043 , eta(2)=.30 ) and faster ( p=.002 , eta(2)=.76 ) reduction in heart rate compared to that seen during placebo treatments . No treatment effect on blood pressure was found . CONCLUSIONS Active acupressure reduced heart rate significantly more than did placebo acupressure during treatments . Although no treatment effect on blood pressure was found , this could be due to 67 % of participants taking antihypertensive medications during the study Background Caregiving can be stressful , potentially creating physical and psychological strain . Substantial evidence has shown that family caregivers suffer from significant health problems arising from the dem and s of caregiving . Although there are programs supporting caregivers , there is little evidence regarding their effectiveness . Acupressure is an ancient Chinese healing method design ed to restore the flow of Qi ( vital energy ) by applying external pressure to acupoints . A r and omized , wait-list controlled trial was developed to evaluate the effectiveness of a self-administered acupressure intervention on caregiver stress ( primary objective ) and stress-related symptoms of fatigue , insomnia , depression , and health-related quality of life ( secondary objectives ) in Chinese caregivers of older family members . Methods Two hundred Chinese participants , aged ≥ 21 years , who are the primary caregivers of an older family member and screen positive for caregiver stress and symptoms of fatigue/insomnia/depression will be recruited from a community setting in Hong Kong . Subjects will be r and omized to receive either an immediate treatment condition ( self-administered acupressure intervention ) or a wait-list control condition . The self-administered acupressure intervention will include ( i ) an individual learning and practice session twice a week for 2 weeks , ( ii ) a home follow-up visit once a week for 2 weeks , and ( iii ) 15-min self- practice twice a day for 6 weeks . The wait-list control group will receive the same acupressure training after the intervention group has completed the intervention . We hypothesize that Chinese family caregivers in the intervention group will have lower levels of caregiver stress , fatigue , insomnia , depression , and higher health-related quality of life after completion of the intervention than participants in the wait-list control group . Discussion This study will provide evidence for the effectiveness of self-administered acupressure in reducing stress and improving symptoms of fatigue , insomnia , depression , and health-related quality of life in Chinese family caregivers . The findings will inform the design of interventions to relieve negative health effects of caregiving . Furthermore , the results can raise community awareness and serve as a basis for policymaking , planning , and allocation of re sources regarding empowerment of family caregivers for self-care . Trial registration Current Controlled Trials NCT02526446 . Registered August 10 , 2015 BACKGROUND : Premedication with sedatives can decrease the discomfort associated with invasive anesthetic procedures . Some research ers have shown that acupressure on the acupuncture extra 1 point is effective for sedation . We investigated whether acupressure on the extra 1 point could alleviate the pain of needle insertion . METHODS : We investigated the effect of acupressure at the extra 1 point or a sham point on needle insertion using verbal rating scale ( VRS ) pain scores and heart rate variability ( HRV ) .  Twenty-two healthy female volunteers were r and omly allocated to two groups : the extra 1 group received acupressure at the extra 1 point , and the sham group received acupressure at a sham point . After starting the electrocardiogram record , a 27-gauge needle was inserted into the skin of a forearm . Thereafter , another needle was inserted into the skin of the other forearm during acupressure . RESULTS : Acupressure at the extra 1 point significantly reduced the VRS , but acupressure at the sham increased the VRS .  Acupressure at the extra 1 significantly reduced the low frequency/high frequency ratio of HRV responding to needle insertion . CONCLUSIONS : Acupressure at the extra 1 point significantly reduced needle insertion pain compared with acupressure at the sham point . Also , acupressure at the extra 1 point significantly reduced the low frequency/high frequency ratio of HRV responding to needle insertion , which implies a reduction in sympathetic nervous system activity & NA ; Motion style acupuncture treatment ( MSAT ) was more effective for pain relief and functional recovery than diclofenac injection in acute low back pain patients with disability . & NA ; Review s of the efficacy of acupuncture as a treatment for acute low back pain ( aLBP ) have shown that there is insufficient evidence for its effect and that more research is needed . Motion style acupuncture treatment ( MSAT ) is novel in that it requires a part of the patient ’s body to move passively or actively while acupuncture needles are retained . A multicenter , r and omized , comparative effectiveness trial was conducted to evaluate the effects of MSAT in aLBP with severe disability . A total of 58 aLBP patients with severe functional disability ( defined per Oswestry Disability Index [ ODI ] ≥60 % ) were recruited and assigned r and omly to receive 1 session of either conventional diclofenac injection ( n = 29 ) or MSAT ( n = 29 ) . The primary outcome measured improvement in LBP using the 10‐point numerical rating scale of LBP , and the secondary outcome assessed disability using the Oswestry Disability Index at 30 minutes and at 2 , 4 , and 24 weeks after treatment . Analyses were by intention to treat . The numerical rating scale of the MSAT group decreased 3.12 ( 95 % confidence interval = 2.26 , 3.98 ; P < .0001 ) more than that of the injection group and the Oswestry Disability Index of the MSAT group decreased 32.95 % ( 95 % confidence interval = 26.88 , 39.03 ; P < .0001 ) more than that of the injection group , respectively . The difference between the 2 groups maintained statistical significance at 2 and 4 weeks after treatment . These results suggest that MSAT has positive effects on immediate pain relief and the functional recovery of aLBP patients with severe disability Background Agitated behavior is a widespread problem that adversely affects the health of nursing home residents and increases the cost of their care . Objective To examine whether modifying environmental stimuli by the use of calming music and h and massage affects agitated behavior in persons with dementia . Method A four group , repeated measures experimental design was used to test the effect of a 10-minute exposure to either calming music , h and massage , or calming music and h and massage simultaneously , or no intervention ( control ) on the frequency and type of agitated behaviors in nursing home residents with dementia ( N = 68 ) . A modified version of the Cohen-Mansfield Agitation Inventory was used to record agitated behaviors . Results Each of the experimental interventions reduced agitation more than no intervention . The benefit was sustained and increased up to one hour following the intervention ( F = 6.47 , p < .01 ) . The increase in benefit over time was similar for each intervention group . When types of agitated behaviors were examined separately , none of the interventions significantly reduced physically aggressive behaviors ( F = 1.93 , p = .09 ) , while physically nonaggressive behaviors decreased during each of the interventions ( F = 3.78 , p < 01 ) . No additive benefit result ed from simultaneous exposure to calming music and h and massage . At one hour following any intervention , verbally agitated behavior decreased more than no intervention . Conclusion Calming music and h and massage alter the immediate environment of agitated nursing home residents to a calm structured surrounding , off setting disturbing stimuli , but no additive benefit was found by combining interventions simultaneously A r and om population -based study using a structured telephone question naire was undertaken to determine the frequency , duration and prevalence of waking cervical spine pain and stiffness , headache , and aching between the scapulae or in the arm and their relationship to age and gender . Seventy-six per cent of households contacted completed the question naire , yielding a total of 812 question naires . Subjects most commonly reported  waking with scapular or arm pain  ( 27 % ) followed by  headache  ( 19 % ) ,  cervical pain  ( 18 % ) and  cervical stiffness  ( 17 % ) . The majority of subjects reported that symptoms lasted for more than an hour on one or two occasions during the week . Subjects who reported the presence of one type of waking symptom were significantly more likely to report other waking symptoms . Females were significantly more likely to wake with a headache than males ( OR 2.5 , 95 % CI 1.6 to 4.0 ) , while all subjects aged over 60 years were significantly less likely to wake with a headache than subjects in other age groups ( OR 0.6 , 95 % CI 0.4 to 1.0 ) . Females exhibited a decline in waking cervical pain , stiffness and headache with increasing age . In contrast , males exhibited a peak prevalence of waking cervical pain , stiffness and headache in the 40 to 59 year age group . The prevalence of waking with aching between the scapulae or in the arm behaved differently from the other symptom groups in both genders AIM AND OBJECTIVE To examine the effects of a nurse-led acupressure programme on the recovery of motor function and daily activities of stroke patients . BACKGROUND Stroke is one of the main causes of death and permanent physical disability in the world . The traditional Chinese medicine ( TCM ) is widely used for the treatment and rehabilitation of people with stroke in China . Physiotherapy or occupational therapy can not be performed several times a day . Therefore , research ers and healthcare providers have been seeking effective and efficient alternative strategies for the rehabilitation of stroke patients . Acupressure , non-invasive and widely accessible to any healthcare professionals , is one of the promising alternatives . METHODS Seventy-eight stroke patients were recruited and r and omly assigned into an intervention or control group , with 39 patients in each . The intervention group received acupressure plus routine care , while the control group received only routine care only . The acupressure treatment was carried out by nurses . Patient 's activities of daily living ( ADL ) and motor function from both groups were evaluated at the point of recruitment , and at the end of the first and third month after stroke . RESULTS The ADL and the Fugl-Meyer motor scores in the intervention group were significantly higher than those in the control group at the end of the third month ( p<0.05 ) . CONCLUSION Nurse-led acupressure programme had positive effects on the recovery of motor function and daily activities of stroke patients . Our study suggests that nurse-led acupressure programmes play an important role in the recovery of stroke patients . RELEVANCE TO CLINICAL PRACTICE Healthcare providers need to think about alternative care methods including acupressure for the rehabilitation of stroke patients . Acupressure is one of the promising alternatives nursing intervention for stroke patients in practice Acupuncture and acupressure points correlate well with sites on the body that have low transcutaneous electrical resistance ( TER ) . Using lightly se date d , adult Sprague-Dawley rats , we identified an acupoint ( i.e. site with low TER ) located on the hind limb of the rat and compared the effects of acupressure at this site on the nociceptive threshold to an adjacent , non-acupoint site ( i.e. site with high TER ) . Focal pressure ( 55.42 + /- 2.2 g ) was applied to the site for 10 minutes and the tail flick response ( TFR ) was determined by draping the distal portion of the tail over a heated wire ( 75 + /- 5 degrees C ) . Three trials were performed during each of three r and omized conditions ( i.e. acupoint , placebo and control ) and the trials were averaged . All rats tested ( 5/5 ) showed a statistically significant increase in TFR following 10 minutes of acupressure at the acupoint compared to placebo or control trials ( p = 0.007 ) . Acupressure at the placebo point result ed in a TFR that was not statistically different from the control . Systemic administration of naloxone completely abolished the tail-flick inhibition induced by acupressure at the acupoint . These data suggest that acupressure elicits an antinociceptive effect in rats that is mediated by the endogenous release of opioids BACKGROUND Ankle sprains occur frequently among young and active people , accounting for almost 2 million injuries per year . Previous reports suggest that acu 
    Output:
    
agent
***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: OBJECTIVES Acupressure , a complementary and alternative medicine ( CAM ) treatment , uses fingertips , rather than needles , to stimulate acupoints on the skin and has been implicated as a successful treatment for a variety of medical disorders . However , acupressure 's underlying mechanisms remain unclear . One theory is that acupoint stimulation modulates autonomic nervous system activity . Previous studies have suggested that acupressure may positively affect heart rate and blood pressure . The current study investigated the effects of a type of acupressure , Jin Shin , on cardiovascular function in stroke survivors , a population that could especially benefit from a treatment promoting cardiovascular health . The study tested the hypothesis that active acupressure treatments would reduce heart rate and blood pressure ( i.e. , induce a greater relaxation response ) above and beyond that seen during placebo acupressure treatments . METHODS A r and omised , placebo-controlled , single-blind crossover design was utilised , in which 16 participants received 8 weeks of either active or placebo acupressure  followed by washout and crossover into the opposite treatment condition . Heart rate and blood pressure measurements were taken throughout treatments . RESULTS Active acupressure treatments were associated with a significantly greater ( p=.043 , eta(2)=.30 ) and faster ( p=.002 , eta(2)=.76 ) reduction in heart rate compared to that seen during placebo treatments . No treatment effect on blood pressure was found . CONCLUSIONS Active acupressure reduced heart rate significantly more than did placebo acupressure during treatments . Although no treatment effect on blood pressure was found , this could be due to 67 % of participants taking antihypertensive medications during the study Background Caregiving can be stressful , potentially creating physical and psychological strain . Substantial evidence has shown that family caregivers suffer from significant health problems arising from the dem and s of caregiving . Although there are programs supporting caregivers , there is little evidence regarding their effectiveness . Acupressure is an ancient Chinese healing method design ed to restore the flow of Qi ( vital energy ) by applying external pressure to acupoints . A r and omized , wait-list controlled trial was developed to evaluate the effectiveness of a self-administered acupressure intervention on caregiver stress ( primary objective ) and stress-related symptoms of fatigue , insomnia , depression , and health-related quality of life ( secondary objectives ) in Chinese caregivers of older family members . Methods Two hundred Chinese participants , aged ≥ 21 years , who are the primary caregivers of an older family member and screen positive for caregiver stress and symptoms of fatigue/insomnia/depression will be recruited from a community setting in Hong Kong . Subjects will be r and omized to receive either an immediate treatment condition ( self-administered acupressure intervention ) or a wait-list control condition . The self-administered acupressure intervention will include ( i ) an individual learning and practice session twice a week for 2 weeks , ( ii ) a home follow-up visit once a week for 2 weeks , and ( iii ) 15-min self- practice twice a day for 6 weeks . The wait-list control group will receive the same acupressure training after the intervention group has completed the intervention . We hypothesize that Chinese family caregivers in the intervention group will have lower levels of caregiver stress , fatigue , insomnia , depression , and higher health-related quality of life after completion of the intervention than participants in the wait-list control group . Discussion This study will provide evidence for the effectiveness of self-administered acupressure in reducing stress and improving symptoms of fatigue , insomnia , depression , and health-related quality of life in Chinese family caregivers . The findings will inform the design of interventions to relieve negative health effects of caregiving . Furthermore , the results can raise community awareness and serve as a basis for policymaking , planning , and allocation of re sources regarding empowerment of family caregivers for self-care . Trial registration Current Controlled Trials NCT02526446 . Registered August 10 , 2015 BACKGROUND : Premedication with sedatives can decrease the discomfort associated with invasive anesthetic procedures . Some research ers have shown that acupressure on the acupuncture extra 1 point is effective for sedation . We investigated whether acupressure on the extra 1 point could alleviate the pain of needle insertion . METHODS : We investigated the effect of acupressure at the extra 1 point or a sham point on needle insertion using verbal rating scale ( VRS ) pain scores and heart rate variability ( HRV ) .  Twenty-two healthy female volunteers were r and omly allocated to two groups : the extra 1 group received acupressure at the extra 1 point , and the sham group received acupressure at a sham point . After starting the electrocardiogram record , a 27-gauge needle was inserted into the skin of a forearm . Thereafter , another needle was inserted into the skin of the other forearm during acupressure . RESULTS : Acupressure at the extra 1 point significantly reduced the VRS , but acupressure at the sham increased the VRS .  Acupressure at the extra 1 significantly reduced the low frequency/high frequency ratio of HRV responding to needle insertion . CONCLUSIONS : Acupressure at the extra 1 point significantly reduced needle insertion pain compared with acupressure at the sham point . Also , acupressure at the extra 1 point significantly reduced the low frequency/high frequency ratio of HRV responding to needle insertion , which implies a reduction in sympathetic nervous system activity & NA ; Motion style acupuncture treatment ( MSAT ) was more effective for pain relief and functional recovery than diclofenac injection in acute low back pain patients with disability . & NA ; Review s of the efficacy of acupuncture as a treatment for acute low back pain ( aLBP ) have shown that there is insufficient evidence for its effect and that more research is needed . Motion style acupuncture treatment ( MSAT ) is novel in that it requires a part of the patient ’s body to move passively or actively while acupuncture needles are retained . A multicenter , r and omized , comparative effectiveness trial was conducted to evaluate the effects of MSAT in aLBP with severe disability . A total of 58 aLBP patients with severe functional disability ( defined per Oswestry Disability Index [ ODI ] ≥60 % ) were recruited and assigned r and omly to receive 1 session of either conventional diclofenac injection ( n = 29 ) or MSAT ( n = 29 ) . The primary outcome measured improvement in LBP using the 10‐point numerical rating scale of LBP , and the secondary outcome assessed disability using the Oswestry Disability Index at 30 minutes and at 2 , 4 , and 24 weeks after treatment . Analyses were by intention to treat . The numerical rating scale of the MSAT group decreased 3.12 ( 95 % confidence interval = 2.26 , 3.98 ; P < .0001 ) more than that of the injection group and the Oswestry Disability Index of the MSAT group decreased 32.95 % ( 95 % confidence interval = 26.88 , 39.03 ; P < .0001 ) more than that of the injection group , respectively . The difference between the 2 groups maintained statistical significance at 2 and 4 weeks after treatment . These results suggest that MSAT has positive effects on immediate pain relief and the functional recovery of aLBP patients with severe disability Background Agitated behavior is a widespread problem that adversely affects the health of nursing home residents and increases the cost of their care . Objective To examine whether modifying environmental stimuli by the use of calming music and h and massage affects agitated behavior in persons with dementia . Method A four group , repeated measures experimental design was used to test the effect of a 10-minute exposure to either calming music , h and massage , or calming music and h and massage simultaneously , or no intervention ( control ) on the frequency and type of agitated behaviors in nursing home residents with dementia ( N = 68 ) . A modified version of the Cohen-Mansfield Agitation Inventory was used to record agitated behaviors . Results Each of the experimental interventions reduced agitation more than no intervention . The benefit was sustained and increased up to one hour following the intervention ( F = 6.47 , p < .01 ) . The increase in benefit over time was similar for each intervention group . When types of agitated behaviors were examined separately , none of the interventions significantly reduced physically aggressive behaviors ( F = 1.93 , p = .09 ) , while physically nonaggressive behaviors decreased during each of the interventions ( F = 3.78 , p < 01 ) . No additive benefit result ed from simultaneous exposure to calming music and h and massage . At one hour following any intervention , verbally agitated behavior decreased more than no intervention . Conclusion Calming music and h and massage alter the immediate environment of agitated nursing home residents to a calm structured surrounding , off setting disturbing stimuli , but no additive benefit was found by combining interventions simultaneously A r and om population -based study using a structured telephone question naire was undertaken to determine the frequency , duration and prevalence of waking cervical spine pain and stiffness , headache , and aching between the scapulae or in the arm and their relationship to age and gender . Seventy-six per cent of households contacted completed the question naire , yielding a total of 812 question naires . Subjects most commonly reported  waking with scapular or arm pain  ( 27 % ) followed by  headache  ( 19 % ) ,  cervical pain  ( 18 % ) and  cervical stiffness  ( 17 % ) . The majority of subjects reported that symptoms lasted for more than an hour on one or two occasions during the week . Subjects who reported the presence of one type of waking symptom were significantly more likely to report other waking symptoms . Females were significantly more likely to wake with a headache than males ( OR 2.5 , 95 % CI 1.6 to 4.0 ) , while all subjects aged over 60 years were significantly less likely to wake with a headache than subjects in other age groups ( OR 0.6 , 95 % CI 0.4 to 1.0 ) . Females exhibited a decline in waking cervical pain , stiffness and headache with increasing age . In contrast , males exhibited a peak prevalence of waking cervical pain , stiffness and headache in the 40 to 59 year age group . The prevalence of waking with aching between the scapulae or in the arm behaved differently from the other symptom groups in both genders AIM AND OBJECTIVE To examine the effects of a nurse-led acupressure programme on the recovery of motor function and daily activities of stroke patients . BACKGROUND Stroke is one of the main causes of death and permanent physical disability in the world . The traditional Chinese medicine ( TCM ) is widely used for the treatment and rehabilitation of people with stroke in China . Physiotherapy or occupational therapy can not be performed several times a day . Therefore , research ers and healthcare providers have been seeking effective and efficient alternative strategies for the rehabilitation of stroke patients . Acupressure , non-invasive and widely accessible to any healthcare professionals , is one of the promising alternatives . METHODS Seventy-eight stroke patients were recruited and r and omly assigned into an intervention or control group , with 39 patients in each . The intervention group received acupressure plus routine care , while the control group received only routine care only . The acupressure treatment was carried out by nurses . Patient 's activities of daily living ( ADL ) and motor function from both groups were evaluated at the point of recruitment , and at the end of the first and third month after stroke . RESULTS The ADL and the Fugl-Meyer motor scores in the intervention group were significantly higher than those in the control group at the end of the third month ( p<0.05 ) . CONCLUSION Nurse-led acupressure programme had positive effects on the recovery of motor function and daily activities of stroke patients . Our study suggests that nurse-led acupressure programmes play an important role in the recovery of stroke patients . RELEVANCE TO CLINICAL PRACTICE Healthcare providers need to think about alternative care methods including acupressure for the rehabilitation of stroke patients . Acupressure is one of the promising alternatives nursing intervention for stroke patients in practice Acupuncture and acupressure points correlate well with sites on the body that have low transcutaneous electrical resistance ( TER ) . Using lightly se date d , adult Sprague-Dawley rats , we identified an acupoint ( i.e. site with low TER ) located on the hind limb of the rat and compared the effects of acupressure at this site on the nociceptive threshold to an adjacent , non-acupoint site ( i.e. site with high TER ) . Focal pressure ( 55.42 + /- 2.2 g ) was applied to the site for 10 minutes and the tail flick response ( TFR ) was determined by draping the distal portion of the tail over a heated wire ( 75 + /- 5 degrees C ) . Three trials were performed during each of three r and omized conditions ( i.e. acupoint , placebo and control ) and the trials were averaged . All rats tested ( 5/5 ) showed a statistically significant increase in TFR following 10 minutes of acupressure at the acupoint compared to placebo or control trials ( p = 0.007 ) . Acupressure at the placebo point result ed in a TFR that was not statistically different from the control . Systemic administration of naloxone completely abolished the tail-flick inhibition induced by acupressure at the acupoint . These data suggest that acupressure elicits an antinociceptive effect in rats that is mediated by the endogenous release of opioids BACKGROUND Ankle sprains occur frequently among young and active people , accounting for almost 2 million injuries per year . Previous reports suggest that acu 
    Output:
    