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: OBJECTIVE To compare training and follow-up effects of combined aerobic and strength training versus aerobic-only training on cognitive and motor function in institutionalized patients with dementia and to explore whether improved motor function mediates improved cognitive function . METHODS Using a 9-week , parallel , three-group , single-blind , r and omized , controlled trial with a follow-up assessment at week 18 , we assessed 109 patients with dementia ( age 85.5 ± 5.1 years ) in a psycho-geriatric nursing home . Each 9-week intervention consisted of 36 , 30-minute sessions . A combined group ( N = 37 ) received and completed two strength and two walking sessions per week , an aerobic group ( N = 36 ) completed four walking sessions , and a social group ( N = 36 ) completed four social visits per  week . Cognitive and motor functions were assessed at baseline , after the 9-week intervention , and after a consecutive 9 weeks of usual care . RESULTS Baseline corrected post-test scores in the combined versus the social group were higher for global cognition , visual memory , verbal memory , executive function , walking endurance , leg muscle strength , and balance . Aerobic versus social group scores were higher for executive function . Follow-up effects reversed toward baseline values . Motor improvement did not significantly mediate cognitive improvement . CONCLUSION Compared with a nonexercise control group , a combination of aerobic and strength training is more effective than aerobic-only training in slowing cognitive and motor decline in patients with dementia . No mediating effects between improvements in cognitive function via improved motor function were found . Future research into the underlying mechanistic associations is needed Background Dementia is among the leading causes of functional loss and disability in older adults . Research has demonstrated that nursing home patients without dementia can improve their function in activities of daily living , strength , balance and mental well being by physical exercise . The evidence on effect of physical exercise among nursing home patients with dementia is scarce and ambiguous . Thus , the primary objective of this study was to investigate the effect of a high intensity functional exercise program on the performance of balance in nursing home residents with dementia . The secondary objective was to examine the effect of this exercise on muscle strength , mobility , activities of daily living , quality of life and neuropsychiatric symptoms . Design and Methods This single blinded r and omized controlled trial was conducted among 170 persons with dementia living in nursing homes . Mean age was 86.7 years ( SD = 7.4 ) and 74 % were women . The participants were r and omly allocated to an intervention ( n = 87 ) or a control group ( n = 83 ) . The intervention consisted of intensive strengthening and balance exercises in small groups twice a week for 12 weeks . The control condition was leisure activities . Results The intervention group improved the score on Bergs Balance Scale by 2.9 points , which was significantly more than the control group who improved by 1.2 points ( p = 0.02 ) . Having exercised 12 times or more was significantly associated with improved strength after intervention ( p<0.05 ) . The level of apathy was lower in the exercise group after the intervention , compared to the control group ( p = 0.048 ) . Conclusion The results from our study indicate that a high intensity functional exercise program improved balance and muscle strength as well as reduced apathy in nursing home patients with dementia . Trial Registration Clinical Trials.gov PURPOSE OF THE STUDY The purpose of this study was to test the impact of Function-Focused Care for the Cognitively Impaired Intervention on nursing home residents with dementia and the nursing assistants who care for them . DESIGN AND METHODS This was a cluster-r and omized controlled trial using repeated measures . A total of 103 cognitively impaired residents and 77 nursing assistants were recruited from four nursing homes . For residents , outcome measures included function , physical activity ( survey and actigraphy ) , mood , behavior , and adverse events ( falls and hospitalization ) . Main outcome measures for nursing assistants included knowledge , beliefs , and performance of function focused care . RESULTS There were significant improvements in the amount and intensity of physical activity ( by survey and actigraphy ) and physical function in the treatment group . In addition , there was a significant decrease in the number of residents who fell during the treatment period with those in the treatment sites having fewer falls ( 28 % vs. 50 % in the control group ) . Nursing assistants were also observed to be providing a greater percentage of function focused care during resident care interactions in the treatment group at 6 months following the completion of baseline measures . IMPLICATION S This study provides some evidence that nursing home residents with severe cognitive impairment can safely and successfully be engaged in physical and functional activities Introduction Many studies have now demonstrated the efficacy of text messaging in positively changing behaviours . We aim ed to identify features and factors that explain the effectiveness of a successful text messaging program in terms of user engagement , perceived usefulness , behavior change and program delivery preferences . Methods Mixed methods qualitative design combining four data sources ; ( i ) analytic data extracted directly from the software system , ( ii ) participant survey , ( iii ) focus groups to identify barriers and enablers to implementation and mechanisms of effect and ( iv ) recruitment screening logs and text message responses to examine engagement . This evaluation was conducted within the TEXT ME trial — a parallel design , single-blind r and omized controlled trial ( RCT ) of 710 patients with coronary heart disease ( CHD ) . Qualitative data were interpreted using inductive thematic analysis . Results 307/352 ( 87 % response rate ) of recruited patients with CHD completed the program evaluation survey at six months and 25 participated in a focus group . Factors increasing engagement included ( i ) ability to save and share messages , ( ii ) having the support of providers and family , ( iii ) a feeling of support through participation in the program , ( iv ) the program being initiated close to the time of a cardiovascular event , ( v ) personalization of the messages , ( vi ) opportunity for initial face-to-face contact with a provider and ( vii ) that program and content was perceived to be from a credible source . Clear themes relating to program delivery were that diet and physical activity messages were most valued , four messages per week was ideal and most participants felt program duration should be provided for at least for six months or longer . Conclusions This study provides context and insight into the factors influencing consumer engagement with a text message program aim ed at improving health-related behavior . The study suggests program components that may enhance potential success but will require integration at the development stage to optimize up-scaling . Trial Registration Australia and New Zeal and Clinical Trials Registry , ACTRN12611000161921 Background Method ological guidelines for intervention reporting emphasise describing intervention content in detail . Despite this , systematic review s of quality improvement ( QI ) implementation interventions continue to be limited by a lack of clarity and detail regarding the intervention content being evaluated . We aim ed to apply the recently developed Behaviour Change Techniques Taxonomy version 1 ( BCTTv1 ) to trials of implementation interventions for managing diabetes to assess the capacity and utility of this taxonomy for characterising active ingredients . Methods Three psychologists independently coded a r and om sample of 23 trials of healthcare system , provider- and /or patient-focused implementation interventions from a systematic review that included 142 such studies . Intervention content was coded using the BCTTv1 , which describes 93 behaviour change techniques ( BCTs ) grouped within 16 categories . We supplemented the generic coding instructions within the BCTTv1 with decision rules and examples from this literature . Results Less than a quarter of possible BCTs within the BCTTv1 were identified . For implementation interventions targeting providers , the most commonly identified BCTs included the following : adding objects to the environment , prompts/cues , instruction on how to perform the behaviour , credible source , goal setting ( outcome ) , feedback on outcome of behaviour , and social support ( practical ) . For implementation interventions also targeting patients , the most commonly identified BCTs included the following : prompts/cues , instruction on how to perform the behaviour , information about health consequences , restructuring the social environment , adding objects to the environment , social support ( practical ) , and goal setting ( behaviour ) . The BCTTv1 mapped well onto implementation interventions directly targeting clinicians and patients and could also be used to examine the impact of system-level interventions on clinician and patient behaviour . Conclusions The BCTTv1 can be used to characterise the active ingredients in trials of implementation interventions and provides specificity of content beyond what is given by broader intervention labels . Identification of BCTs may provide a more helpful means of accumulating knowledge on the content used in trials of implementation interventions , which may help to better inform replication efforts . In addition , prospect i ve use of a behaviour change techniques taxonomy for developing and reporting intervention content would further aid in building a cumulative science of effective implementation interventions Background Research indicates that exercise can have a positive effect on both physical and mental health in nursing home patients with dementia , however the lasting effect is rarely studied . In a previously published article we investigated the immediate effect of a 12 weeks functional exercise program on physical function and mental health in nursing home residents with dementia . In this paper we studied the long-term effect of this exercise program . We explored the differences between the exercise and control group from baseline to 6 months follow-up and during the detraining period from month 3 to 6 . Methods A single blind , r and omized controlled trial was conducted and a total of 170 nursing home residents with dementia were included . The participants were r and omly allocated to an intervention ( n = 87 ) or a control group ( n = 83 ) . The intervention consisted of intensive strengthening and balance exercises in small groups twice a week for 12 weeks . The control condition was leisure activities . Thirty participants were lost between baseline and six-month follow-up . Linear mixed model analyses for repeated measurements were used to investigate the effect of exercise after detraining period . Results The exercise group improved their scores on Berg Balance Scale from baseline to 6 months follow-up by 2.7 points in average . The control group deteriorated in the same period and the difference between groups was statistically significant ( p = 0.031 ) . The exercise group also scored better on NPI agitation sub-score after 6 months ( p = 0.045 ) . Conclusion The results demonstrate long-time positive effects of a high intensity functional exercise program on balance and indicate a positive effect on agitation , after an intervention period of 12 weeks followed by a detraining period of 12 weeks . Identifier at Clinical Trials.gov : IMPORTANCE Few rigorous clinical trials have investigated the effectiveness of exercise on the physical functioning of patients with Alzheimer disease ( AD ) . OBJECTIVES To investigate the effects of intense and long-term exercise on the physical functioning and mobility of home-dwelling patients with AD and to explore its effects on the use and costs of health and social services . DESIGN A r and omized controlled trial . SETTING AND PARTICIPANTS A total of 210 home-dwelling patients with AD living with their spousal caregiver . INTERVENTIONS The 3 trial arms included ( 1 ) group-based exercise ( GE ; 4-hour sessions with approximately 1-hour training ) and ( 2 ) tailored home-based exercise ( HE ; 1-hour training ) , both twice a week for 1 year , and ( 3 ) a control group ( CG ) receiving the usual community care . MAIN OUTCOME MEASURES The Functional Independence Measure ( FIM ) , the Short Physical Performance Battery , and information on the use and costs of social and health care services . RESULTS All groups deteriorated in functioning during the year after r and omization , but deterioration was significantly faster in the CG than in the HE or GE group at 6 ( P = .003 ) and 12 ( P = .015 ) months . The FIM changes at 12 months were -7.1 ( 95 % CI , -3.7 to -10.5 ) , -10.3 ( 95 % CI , -6.7 to -13.9 ) , and -14.4 ( 95 % CI , -10.9 to -18.0 ) in the HE group , GE group , and CG , respectively . The HE and GE groups had significantly fewer falls than the CG during the follow-up year . The total costs of health and social services for the HE patient-caregiver dyads ( in US dollars per dyad per year ) were $ 25,112 ( 95 % CI , $ 17,642 to $ 32,581 ) ( P = .13 for comparison with the CG ) , $ 22,066 in the GE group ( $ 15,931 to $ 28,199 ; P = .03 vs CG ) , and $ 34,121 ( $ 24,559 to $ 43,681 ) in the CG . CONCLUSIONS AND RELEVANCE An intensive and long-term exercise program had beneficial effects on the physical functioning of patients with AD without increasing the total costs of health and social services or causing any significant adverse effects . TRIAL REGISTRATION anzctr.org.au Identifier : ACTRN12608000037303 Background Preventing and rehabilitating gait disorders in people with dementia during early disease stage is of high importance for staying independent and ambulating safely . However , the evidence gathered in r and omized controlled trials ( RCTs ) on the effectiveness of exercise training for improving spatio-temporal gait parameters in people with dementia is scarce . The aim of the present study was to determine whether a specific , st and ardized training regimen can improve gait characteristics in people with dementia . Methods Sixty-one individuals ( mean age : 81.9 years ) with confirmed mild to moderate stage dementia took part in a 3-month double-blinded outpatient RCT . Subjects in the intervention group ( IG ) received supervised , progressive resistance and functional group training for 3 months ( 2 times per week for two hours ) specifically developed for people with dementia . Subjects in the control group ( CG ) conducted a 
    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: OBJECTIVE To compare training and follow-up effects of combined aerobic and strength training versus aerobic-only training on cognitive and motor function in institutionalized patients with dementia and to explore whether improved motor function mediates improved cognitive function . METHODS Using a 9-week , parallel , three-group , single-blind , r and omized , controlled trial with a follow-up assessment at week 18 , we assessed 109 patients with dementia ( age 85.5 ± 5.1 years ) in a psycho-geriatric nursing home . Each 9-week intervention consisted of 36 , 30-minute sessions . A combined group ( N = 37 ) received and completed two strength and two walking sessions per week , an aerobic group ( N = 36 ) completed four walking sessions , and a social group ( N = 36 ) completed four social visits per  week . Cognitive and motor functions were assessed at baseline , after the 9-week intervention , and after a consecutive 9 weeks of usual care . RESULTS Baseline corrected post-test scores in the combined versus the social group were higher for global cognition , visual memory , verbal memory , executive function , walking endurance , leg muscle strength , and balance . Aerobic versus social group scores were higher for executive function . Follow-up effects reversed toward baseline values . Motor improvement did not significantly mediate cognitive improvement . CONCLUSION Compared with a nonexercise control group , a combination of aerobic and strength training is more effective than aerobic-only training in slowing cognitive and motor decline in patients with dementia . No mediating effects between improvements in cognitive function via improved motor function were found . Future research into the underlying mechanistic associations is needed Background Dementia is among the leading causes of functional loss and disability in older adults . Research has demonstrated that nursing home patients without dementia can improve their function in activities of daily living , strength , balance and mental well being by physical exercise . The evidence on effect of physical exercise among nursing home patients with dementia is scarce and ambiguous . Thus , the primary objective of this study was to investigate the effect of a high intensity functional exercise program on the performance of balance in nursing home residents with dementia . The secondary objective was to examine the effect of this exercise on muscle strength , mobility , activities of daily living , quality of life and neuropsychiatric symptoms . Design and Methods This single blinded r and omized controlled trial was conducted among 170 persons with dementia living in nursing homes . Mean age was 86.7 years ( SD = 7.4 ) and 74 % were women . The participants were r and omly allocated to an intervention ( n = 87 ) or a control group ( n = 83 ) . The intervention consisted of intensive strengthening and balance exercises in small groups twice a week for 12 weeks . The control condition was leisure activities . Results The intervention group improved the score on Bergs Balance Scale by 2.9 points , which was significantly more than the control group who improved by 1.2 points ( p = 0.02 ) . Having exercised 12 times or more was significantly associated with improved strength after intervention ( p<0.05 ) . The level of apathy was lower in the exercise group after the intervention , compared to the control group ( p = 0.048 ) . Conclusion The results from our study indicate that a high intensity functional exercise program improved balance and muscle strength as well as reduced apathy in nursing home patients with dementia . Trial Registration Clinical Trials.gov PURPOSE OF THE STUDY The purpose of this study was to test the impact of Function-Focused Care for the Cognitively Impaired Intervention on nursing home residents with dementia and the nursing assistants who care for them . DESIGN AND METHODS This was a cluster-r and omized controlled trial using repeated measures . A total of 103 cognitively impaired residents and 77 nursing assistants were recruited from four nursing homes . For residents , outcome measures included function , physical activity ( survey and actigraphy ) , mood , behavior , and adverse events ( falls and hospitalization ) . Main outcome measures for nursing assistants included knowledge , beliefs , and performance of function focused care . RESULTS There were significant improvements in the amount and intensity of physical activity ( by survey and actigraphy ) and physical function in the treatment group . In addition , there was a significant decrease in the number of residents who fell during the treatment period with those in the treatment sites having fewer falls ( 28 % vs. 50 % in the control group ) . Nursing assistants were also observed to be providing a greater percentage of function focused care during resident care interactions in the treatment group at 6 months following the completion of baseline measures . IMPLICATION S This study provides some evidence that nursing home residents with severe cognitive impairment can safely and successfully be engaged in physical and functional activities Introduction Many studies have now demonstrated the efficacy of text messaging in positively changing behaviours . We aim ed to identify features and factors that explain the effectiveness of a successful text messaging program in terms of user engagement , perceived usefulness , behavior change and program delivery preferences . Methods Mixed methods qualitative design combining four data sources ; ( i ) analytic data extracted directly from the software system , ( ii ) participant survey , ( iii ) focus groups to identify barriers and enablers to implementation and mechanisms of effect and ( iv ) recruitment screening logs and text message responses to examine engagement . This evaluation was conducted within the TEXT ME trial — a parallel design , single-blind r and omized controlled trial ( RCT ) of 710 patients with coronary heart disease ( CHD ) . Qualitative data were interpreted using inductive thematic analysis . Results 307/352 ( 87 % response rate ) of recruited patients with CHD completed the program evaluation survey at six months and 25 participated in a focus group . Factors increasing engagement included ( i ) ability to save and share messages , ( ii ) having the support of providers and family , ( iii ) a feeling of support through participation in the program , ( iv ) the program being initiated close to the time of a cardiovascular event , ( v ) personalization of the messages , ( vi ) opportunity for initial face-to-face contact with a provider and ( vii ) that program and content was perceived to be from a credible source . Clear themes relating to program delivery were that diet and physical activity messages were most valued , four messages per week was ideal and most participants felt program duration should be provided for at least for six months or longer . Conclusions This study provides context and insight into the factors influencing consumer engagement with a text message program aim ed at improving health-related behavior . The study suggests program components that may enhance potential success but will require integration at the development stage to optimize up-scaling . Trial Registration Australia and New Zeal and Clinical Trials Registry , ACTRN12611000161921 Background Method ological guidelines for intervention reporting emphasise describing intervention content in detail . Despite this , systematic review s of quality improvement ( QI ) implementation interventions continue to be limited by a lack of clarity and detail regarding the intervention content being evaluated . We aim ed to apply the recently developed Behaviour Change Techniques Taxonomy version 1 ( BCTTv1 ) to trials of implementation interventions for managing diabetes to assess the capacity and utility of this taxonomy for characterising active ingredients . Methods Three psychologists independently coded a r and om sample of 23 trials of healthcare system , provider- and /or patient-focused implementation interventions from a systematic review that included 142 such studies . Intervention content was coded using the BCTTv1 , which describes 93 behaviour change techniques ( BCTs ) grouped within 16 categories . We supplemented the generic coding instructions within the BCTTv1 with decision rules and examples from this literature . Results Less than a quarter of possible BCTs within the BCTTv1 were identified . For implementation interventions targeting providers , the most commonly identified BCTs included the following : adding objects to the environment , prompts/cues , instruction on how to perform the behaviour , credible source , goal setting ( outcome ) , feedback on outcome of behaviour , and social support ( practical ) . For implementation interventions also targeting patients , the most commonly identified BCTs included the following : prompts/cues , instruction on how to perform the behaviour , information about health consequences , restructuring the social environment , adding objects to the environment , social support ( practical ) , and goal setting ( behaviour ) . The BCTTv1 mapped well onto implementation interventions directly targeting clinicians and patients and could also be used to examine the impact of system-level interventions on clinician and patient behaviour . Conclusions The BCTTv1 can be used to characterise the active ingredients in trials of implementation interventions and provides specificity of content beyond what is given by broader intervention labels . Identification of BCTs may provide a more helpful means of accumulating knowledge on the content used in trials of implementation interventions , which may help to better inform replication efforts . In addition , prospect i ve use of a behaviour change techniques taxonomy for developing and reporting intervention content would further aid in building a cumulative science of effective implementation interventions Background Research indicates that exercise can have a positive effect on both physical and mental health in nursing home patients with dementia , however the lasting effect is rarely studied . In a previously published article we investigated the immediate effect of a 12 weeks functional exercise program on physical function and mental health in nursing home residents with dementia . In this paper we studied the long-term effect of this exercise program . We explored the differences between the exercise and control group from baseline to 6 months follow-up and during the detraining period from month 3 to 6 . Methods A single blind , r and omized controlled trial was conducted and a total of 170 nursing home residents with dementia were included . The participants were r and omly allocated to an intervention ( n = 87 ) or a control group ( n = 83 ) . The intervention consisted of intensive strengthening and balance exercises in small groups twice a week for 12 weeks . The control condition was leisure activities . Thirty participants were lost between baseline and six-month follow-up . Linear mixed model analyses for repeated measurements were used to investigate the effect of exercise after detraining period . Results The exercise group improved their scores on Berg Balance Scale from baseline to 6 months follow-up by 2.7 points in average . The control group deteriorated in the same period and the difference between groups was statistically significant ( p = 0.031 ) . The exercise group also scored better on NPI agitation sub-score after 6 months ( p = 0.045 ) . Conclusion The results demonstrate long-time positive effects of a high intensity functional exercise program on balance and indicate a positive effect on agitation , after an intervention period of 12 weeks followed by a detraining period of 12 weeks . Identifier at Clinical Trials.gov : IMPORTANCE Few rigorous clinical trials have investigated the effectiveness of exercise on the physical functioning of patients with Alzheimer disease ( AD ) . OBJECTIVES To investigate the effects of intense and long-term exercise on the physical functioning and mobility of home-dwelling patients with AD and to explore its effects on the use and costs of health and social services . DESIGN A r and omized controlled trial . SETTING AND PARTICIPANTS A total of 210 home-dwelling patients with AD living with their spousal caregiver . INTERVENTIONS The 3 trial arms included ( 1 ) group-based exercise ( GE ; 4-hour sessions with approximately 1-hour training ) and ( 2 ) tailored home-based exercise ( HE ; 1-hour training ) , both twice a week for 1 year , and ( 3 ) a control group ( CG ) receiving the usual community care . MAIN OUTCOME MEASURES The Functional Independence Measure ( FIM ) , the Short Physical Performance Battery , and information on the use and costs of social and health care services . RESULTS All groups deteriorated in functioning during the year after r and omization , but deterioration was significantly faster in the CG than in the HE or GE group at 6 ( P = .003 ) and 12 ( P = .015 ) months . The FIM changes at 12 months were -7.1 ( 95 % CI , -3.7 to -10.5 ) , -10.3 ( 95 % CI , -6.7 to -13.9 ) , and -14.4 ( 95 % CI , -10.9 to -18.0 ) in the HE group , GE group , and CG , respectively . The HE and GE groups had significantly fewer falls than the CG during the follow-up year . The total costs of health and social services for the HE patient-caregiver dyads ( in US dollars per dyad per year ) were $ 25,112 ( 95 % CI , $ 17,642 to $ 32,581 ) ( P = .13 for comparison with the CG ) , $ 22,066 in the GE group ( $ 15,931 to $ 28,199 ; P = .03 vs CG ) , and $ 34,121 ( $ 24,559 to $ 43,681 ) in the CG . CONCLUSIONS AND RELEVANCE An intensive and long-term exercise program had beneficial effects on the physical functioning of patients with AD without increasing the total costs of health and social services or causing any significant adverse effects . TRIAL REGISTRATION anzctr.org.au Identifier : ACTRN12608000037303 Background Preventing and rehabilitating gait disorders in people with dementia during early disease stage is of high importance for staying independent and ambulating safely . However , the evidence gathered in r and omized controlled trials ( RCTs ) on the effectiveness of exercise training for improving spatio-temporal gait parameters in people with dementia is scarce . The aim of the present study was to determine whether a specific , st and ardized training regimen can improve gait characteristics in people with dementia . Methods Sixty-one individuals ( mean age : 81.9 years ) with confirmed mild to moderate stage dementia took part in a 3-month double-blinded outpatient RCT . Subjects in the intervention group ( IG ) received supervised , progressive resistance and functional group training for 3 months ( 2 times per week for two hours ) specifically developed for people with dementia . Subjects in the control group ( CG ) conducted a 
    Output:
    