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: BACKGROUND This study examined the effects of brief daily yogic meditation on mental health , cognitive functioning , and immune cell telomerase activity in family dementia caregivers with mild depressive symptoms . METHODS Thirty-nine family dementia caregivers ( mean age 60.3 years old ( SD = 10.2 ) ) were r and omized to practicing Kirtan Kriya or listening to relaxation music for 12 min per day for 8 weeks . The severity of depressive symptoms , mental and cognitive functioning were assessed at baseline and follow-up . Telomerase activity in peripheral blood mononuclear cells ( PMBC ) was examined in peripheral P BMC pre-intervention and post-intervention . RESULTS The meditation group showed significantly lower levels of depressive symptoms and greater improvement in mental health and cognitive functioning compared with the relaxation group . In the meditation group , 65.2 % showed 50 % improvement on the Hamilton Depression Rating scale and 52 % of the participants showed 50 % improvement on the Mental Health Composite Summary score of the Short Form-36 scale compared with 31.2 % and 19 % , respectively , in the relaxation group ( p < 0.05 ) . The meditation group showed 43 % improvement in telomerase activity compared with 3.7 % in the relaxation group ( p = 0.05 ) . CONCLUSION This pilot study found that brief daily meditation practice s by family dementia caregivers can lead to improved mental and cognitive functioning and lower levels of depressive symptoms . This improvement is accompanied by an increase in telomerase activity suggesting improvement in stress-induced cellular aging . These results need to be confirmed in a larger sample CONTEXT Dementia care giving can lead to increased stress , physical and psychosocial morbidity , and mortality . Anecdotal evidence suggests that hospice care provided to people with dementia and their caregivers may buffer caregivers from some of the adverse outcomes associated with family caregiving in Alzheimer 's Disease ( AD ) . OBJECTIVES This pilot study examined psychological and physical outcomes among 32 spousal caregivers of patients with AD . It was hypothesized that caregivers who utilized hospice services would demonstrate better outcomes after the death of their spouse than caregivers who did not utilize hospice . METHODS The charts of all spousal caregivers enrolled in a larger longitudinal study from 2001 to 2006 ( N=120 ) were review ed , and participants whose spouse had died were identified . Of these , those who received hospice care ( n=10 ) were compared to those who did not ( n=22 ) for various physiological and psychological measures of stress , both before and after the death of the care recipient . An Analysis of Covariance ( ANCOVA ) , with postdeath scores as the dependent variable and pre-death scores as covariates , was used for all variables . RESULTS Significant group differences were found in postdeath depressive symptoms ( HAM-D ; F(1,29)=6.10 , p<0.05 ) and anxiety symptoms ( HAM-A ; F(1,29)=5.71 , p<0.05 ) . Most psychological outcome variables demonstrated moderate effect sizes with a Cohen 's d of>0.5 between groups . CONCLUSIONS These data suggest that hospice enrollment may ameliorate the detrimental psychological effects in caregivers who have lost a spouse with Alzheimer 's Disease . Based on these pilot data , further prospect i ve investigation is warranted Providing care to a family member with dementia is conceptualized as a chronic stressor with adverse psychological and physical effects . The purpose of this pilot study was to evaluate mood and immune outcomes of caregivers exposed to a community-based psychoeducational nursing intervention based on the progressively lowered stress threshold ( PLST ) model . The PLST intervention is design ed to strengthen the psychological re sources of dementia caregivers by teaching methods of preventing and /or managing behavioral problems exhibited by the person with dementia . Mood and immune outcomes were compared between caregivers r and omly assigned to receive either the PLST or a comparison intervention . Results of this pilot study suggest that caregivers who received the PLST intervention showed significantly stronger T-cell proliferative responses to both PHA and ConA , indicating an improvement in T-cell immune function immediately after the in-home intervention ( T2 ) and again after 6 months of telephone support for application of the PLST model ( T3 ) . Findings do not support the hypothesis that the PLST intervention had a significant effect on total mood disturbance or natural killer cell cytotoxicity over the course of the study BACKGROUND The dexamethasone/corticotropin releasing hormone ( Dex/CRH ) test has been proposed as a potential tool for identifying endophenotypes relevant to mood disorders . Several studies have shown abnormal cortisol reactivity in phenotypically healthy adults without psychiatric disorders as a function of exposure to adverse early environments . METHODS After a battery of self-report and interview assessment s , 230 adults without major Axis I Disorders completed the Dex/CRH test . Childhood maltreatment was evaluated with the Childhood Trauma Question naire . Effect of childhood emotional abuse ( EA ) on cortisol responses to the Dex/CRH test was examined with repeated measures general linear models , including age , gender , and other types of maltreatment . Post hoc models examined the significant interaction between EA and age and tested the stability of the main findings with selected covariates . RESULTS A history of self-reported childhood EA independently and significantly diminished cortisol response . This effect was amplified with advancing subject age and was independent of the effects of other types of childhood maltreatment , lifetime diagnoses , and symptom scores . CONCLUSIONS Dampened cortisol reactivity might be a consequence of childhood EA that is cumulative over time . Prospect i ve longitudinal investigation is needed to evaluate the potential of this proposed endophenotype BACKGROUND Although yoga and meditation have been used for stress reduction with reported improvement in inflammation , little is known about the biological mechanisms mediating such effects . The present study examined if a yogic meditation might alter the activity of inflammatory and antiviral transcription control pathways that shape immune cell gene expression . METHODS Forty-five family dementia caregivers were r and omized to either Kirtan Kriya Meditation ( KKM ) or Relaxing Music ( RM ) listening for 12 min daily for 8 weeks and 39 caregivers completed the study .  Genome-wide transcriptional profiles were collected from peripheral blood leukocytes sample d at baseline and 8-week follow-up . Promoter-based bioinformatics analyses tested the hypothesis that observed transcriptional alterations were structured by reduced activity of the pro-inflammatory nuclear factor (NF)-κB family of transcription factors and increased activity of Interferon Response Factors ( IRFs ; i.e. , reversal of patterns previously linked to stress ) . RESULTS In response to KKM treatment , 68 genes were found to be differentially expressed ( 19 up-regulated , 49 down-regulated ) after adjusting for potentially confounded differences in sex , illness burden , and BMI . Up-regulated genes included immunoglobulin-related transcripts . Down-regulated transcripts included pro-inflammatory cytokines and activation-related immediate-early genes . Transcript origin analyses identified plasmacytoid dendritic cells and B lymphocytes as the primary cellular context of these transcriptional alterations ( both p<.001 ) . Promoter-based bioinformatic analysis implicated reduced NF-κB signaling and increased activity of IRF1 in structuring those effects ( both p<.05 ) . CONCLUSION A brief daily yogic meditation intervention may reverse the pattern of increased NF-κB-related transcription of pro-inflammatory cytokines and decreased IRF1-related transcription of innate antiviral response genes previously observed in healthy individuals confronting a significant life stressor Background Dementia is a prevalent neurodegenerative disorder affecting an estimated 24.3 million people across the globe . The burden on those caring for people with dementia is substantial , with widespread implication s for the caregiver , the care recipient and the community . Relaxation techniques , such as Transcendental Meditation ® ( TM ) , have been shown to reduce stress and anxiety in healthy workers ; similar benefits are anticipated in dementia caregivers . The objective of this study was to ascertain whether TM can improve psychological stress , quality of life , affect and cognitive performance in dementia caregivers . Methods The study was conducted as a pilot prospect i ve , multi-centre , community-based , r and omised wait-list controlled trial . Community-dwelling caregivers of persons with diagnosed dementia were r and omly assigned to a 12-week ( 14-hour ) TM training program or wait-list control . Participants were assessed for quality of life , stress , affect , cognitive performance and adverse effects . The feasibility of the study was also evaluated . Results Seventeen caregivers were recruited and r and omised .  Improvements in WebNeuro response speed scores over time were significantly ( p = 0.03 ) greater in the TM group relative to control . Changes between groups over time in all other primary and secondary outcome measures did not reach statistical significance . However , there was a trend toward greater improvement in WebNeuro stress , depression and negativity bias scores in the TM group . Adverse events were reported amongst 63 % of TM-treated subjects ; however , events were generally transient , of mild-moderate intensity and only ‘ possibly ’ related to TM . Conclusions Dementia caregivers exposed to TM demonstrated varying degrees of improvement in several measures of cognitive function , mood , quality of life and stress following exposure to TM . However , as the pilot study was underpowered , no firm conclusions can be made about the effectiveness of TM in this caregiver population . Findings from full-scale trials are now warranted . Trial registration Australian New Zeal and Clinical Trial Registry ACTRN12613000184774 ( Registered 15th February 2013 ) The emerging concept of psychobiotics — live microorganisms with a potential mental health benefit — represents a novel approach for the management of stress-related conditions . The majority of studies have focused on animal models . Recent pre clinical studies have identified the B. longum 1714 strain as a putative psychobiotic with an impact on stress-related behaviors , physiology and cognitive performance . Whether such pre clinical effects could be translated to healthy human volunteers remains unknown . We tested whether psychobiotic consumption could affect the stress response , cognition and brain activity patterns . In a within- participants design , healthy volunteers ( N=22 ) completed cognitive assessment s , resting electroencephalography and were exposed to a socially evaluated cold pressor test at baseline , post-placebo and post-psychobiotic . Increases in cortisol output and subjective anxiety in response to the socially evaluated cold pressor test were attenuated . Furthermore , daily reported stress was reduced by psychobiotic consumption . We also observed subtle improvements in hippocampus-dependent visuospatial memory performance , as well as enhanced frontal midline electroencephalographic mobility following psychobiotic consumption . These subtle but clear benefits are in line with the predicted impact from pre clinical screening platforms . Our results indicate that consumption of B. longum 1714 is associated with reduced stress and improved memory . Further studies are warranted to evaluate the benefits of this putative psychobiotic in relevant stress-related conditions and to unravel the mechanisms underlying such effects Familial  caregivers of patients with Alzheimer 's disease exhibit reduced quality of life and increased stress levels . The aim of this study was to investigate the effects of an 8-week yoga and compassion meditation program on the perceived stress , anxiety , depression , and salivary cortisol levels in familial caregivers . A total of 46 volunteers were r and omly assigned to participate in a stress-reduction program for a 2-month period ( yoga and compassion meditation program — YCMP group ) ( n = 25 ) or an untreated group for the same period of time ( control group ) ( n = 21 ) . The levels of stress , anxiety , depression , and morning salivary cortisol of the participants were measured before and after intervention . The groups were initially homogeneous ; however , after intervention , the groups diverged significantly . The YCMP group exhibited a reduction of the stress ( P < 0.05 ) , anxiety ( P < 0.000001 ) , and depression ( P < 0.00001 ) levels , as well as a reduction in the concentration of salivary cortisol ( P < 0.05 ) . Our study suggests that an 8-week yoga and compassion meditation program may offer an effective intervention for reducing perceived stress , anxiety , depression , and salivary cortisol in familial caregivers Rationale A visuospatial episodic memory impairment has recently been identified in irritable bowel syndrome . Increased tryptophan metabolism along the kynurenine pathway has also been reported in irritable bowel syndrome , which may play a role in altered cognitive performance as peripheral kynurenine can cross the blood brain barrier and lead to the production of neuroactive metabolites , which modulate glutamatergic and cholinergic signalling , key neurotransmitter systems involved in cognitive function . Objectives Utilising the acute tryptophan depletion ( ATD ) protocol , the aim of this study was to examine if manipulating peripheral levels of tryptophan regulates cognitive performance in irritable bowel syndrome and also to determine for the first time if the ATD protocol alters kynurenine supply to the central nervous system . Methods In this double-blind , placebo-controlled , crossover design study , nine female patients with irritable bowel syndrome and 14 matched female healthy controls participant completed a range 
    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: BACKGROUND This study examined the effects of brief daily yogic meditation on mental health , cognitive functioning , and immune cell telomerase activity in family dementia caregivers with mild depressive symptoms . METHODS Thirty-nine family dementia caregivers ( mean age 60.3 years old ( SD = 10.2 ) ) were r and omized to practicing Kirtan Kriya or listening to relaxation music for 12 min per day for 8 weeks . The severity of depressive symptoms , mental and cognitive functioning were assessed at baseline and follow-up . Telomerase activity in peripheral blood mononuclear cells ( PMBC ) was examined in peripheral P BMC pre-intervention and post-intervention . RESULTS The meditation group showed significantly lower levels of depressive symptoms and greater improvement in mental health and cognitive functioning compared with the relaxation group . In the meditation group , 65.2 % showed 50 % improvement on the Hamilton Depression Rating scale and 52 % of the participants showed 50 % improvement on the Mental Health Composite Summary score of the Short Form-36 scale compared with 31.2 % and 19 % , respectively , in the relaxation group ( p < 0.05 ) . The meditation group showed 43 % improvement in telomerase activity compared with 3.7 % in the relaxation group ( p = 0.05 ) . CONCLUSION This pilot study found that brief daily meditation practice s by family dementia caregivers can lead to improved mental and cognitive functioning and lower levels of depressive symptoms . This improvement is accompanied by an increase in telomerase activity suggesting improvement in stress-induced cellular aging . These results need to be confirmed in a larger sample CONTEXT Dementia care giving can lead to increased stress , physical and psychosocial morbidity , and mortality . Anecdotal evidence suggests that hospice care provided to people with dementia and their caregivers may buffer caregivers from some of the adverse outcomes associated with family caregiving in Alzheimer 's Disease ( AD ) . OBJECTIVES This pilot study examined psychological and physical outcomes among 32 spousal caregivers of patients with AD . It was hypothesized that caregivers who utilized hospice services would demonstrate better outcomes after the death of their spouse than caregivers who did not utilize hospice . METHODS The charts of all spousal caregivers enrolled in a larger longitudinal study from 2001 to 2006 ( N=120 ) were review ed , and participants whose spouse had died were identified . Of these , those who received hospice care ( n=10 ) were compared to those who did not ( n=22 ) for various physiological and psychological measures of stress , both before and after the death of the care recipient . An Analysis of Covariance ( ANCOVA ) , with postdeath scores as the dependent variable and pre-death scores as covariates , was used for all variables . RESULTS Significant group differences were found in postdeath depressive symptoms ( HAM-D ; F(1,29)=6.10 , p<0.05 ) and anxiety symptoms ( HAM-A ; F(1,29)=5.71 , p<0.05 ) . Most psychological outcome variables demonstrated moderate effect sizes with a Cohen 's d of>0.5 between groups . CONCLUSIONS These data suggest that hospice enrollment may ameliorate the detrimental psychological effects in caregivers who have lost a spouse with Alzheimer 's Disease . Based on these pilot data , further prospect i ve investigation is warranted Providing care to a family member with dementia is conceptualized as a chronic stressor with adverse psychological and physical effects . The purpose of this pilot study was to evaluate mood and immune outcomes of caregivers exposed to a community-based psychoeducational nursing intervention based on the progressively lowered stress threshold ( PLST ) model . The PLST intervention is design ed to strengthen the psychological re sources of dementia caregivers by teaching methods of preventing and /or managing behavioral problems exhibited by the person with dementia . Mood and immune outcomes were compared between caregivers r and omly assigned to receive either the PLST or a comparison intervention . Results of this pilot study suggest that caregivers who received the PLST intervention showed significantly stronger T-cell proliferative responses to both PHA and ConA , indicating an improvement in T-cell immune function immediately after the in-home intervention ( T2 ) and again after 6 months of telephone support for application of the PLST model ( T3 ) . Findings do not support the hypothesis that the PLST intervention had a significant effect on total mood disturbance or natural killer cell cytotoxicity over the course of the study BACKGROUND The dexamethasone/corticotropin releasing hormone ( Dex/CRH ) test has been proposed as a potential tool for identifying endophenotypes relevant to mood disorders . Several studies have shown abnormal cortisol reactivity in phenotypically healthy adults without psychiatric disorders as a function of exposure to adverse early environments . METHODS After a battery of self-report and interview assessment s , 230 adults without major Axis I Disorders completed the Dex/CRH test . Childhood maltreatment was evaluated with the Childhood Trauma Question naire . Effect of childhood emotional abuse ( EA ) on cortisol responses to the Dex/CRH test was examined with repeated measures general linear models , including age , gender , and other types of maltreatment . Post hoc models examined the significant interaction between EA and age and tested the stability of the main findings with selected covariates . RESULTS A history of self-reported childhood EA independently and significantly diminished cortisol response . This effect was amplified with advancing subject age and was independent of the effects of other types of childhood maltreatment , lifetime diagnoses , and symptom scores . CONCLUSIONS Dampened cortisol reactivity might be a consequence of childhood EA that is cumulative over time . Prospect i ve longitudinal investigation is needed to evaluate the potential of this proposed endophenotype BACKGROUND Although yoga and meditation have been used for stress reduction with reported improvement in inflammation , little is known about the biological mechanisms mediating such effects . The present study examined if a yogic meditation might alter the activity of inflammatory and antiviral transcription control pathways that shape immune cell gene expression . METHODS Forty-five family dementia caregivers were r and omized to either Kirtan Kriya Meditation ( KKM ) or Relaxing Music ( RM ) listening for 12 min daily for 8 weeks and 39 caregivers completed the study .  Genome-wide transcriptional profiles were collected from peripheral blood leukocytes sample d at baseline and 8-week follow-up . Promoter-based bioinformatics analyses tested the hypothesis that observed transcriptional alterations were structured by reduced activity of the pro-inflammatory nuclear factor (NF)-κB family of transcription factors and increased activity of Interferon Response Factors ( IRFs ; i.e. , reversal of patterns previously linked to stress ) . RESULTS In response to KKM treatment , 68 genes were found to be differentially expressed ( 19 up-regulated , 49 down-regulated ) after adjusting for potentially confounded differences in sex , illness burden , and BMI . Up-regulated genes included immunoglobulin-related transcripts . Down-regulated transcripts included pro-inflammatory cytokines and activation-related immediate-early genes . Transcript origin analyses identified plasmacytoid dendritic cells and B lymphocytes as the primary cellular context of these transcriptional alterations ( both p<.001 ) . Promoter-based bioinformatic analysis implicated reduced NF-κB signaling and increased activity of IRF1 in structuring those effects ( both p<.05 ) . CONCLUSION A brief daily yogic meditation intervention may reverse the pattern of increased NF-κB-related transcription of pro-inflammatory cytokines and decreased IRF1-related transcription of innate antiviral response genes previously observed in healthy individuals confronting a significant life stressor Background Dementia is a prevalent neurodegenerative disorder affecting an estimated 24.3 million people across the globe . The burden on those caring for people with dementia is substantial , with widespread implication s for the caregiver , the care recipient and the community . Relaxation techniques , such as Transcendental Meditation ® ( TM ) , have been shown to reduce stress and anxiety in healthy workers ; similar benefits are anticipated in dementia caregivers . The objective of this study was to ascertain whether TM can improve psychological stress , quality of life , affect and cognitive performance in dementia caregivers . Methods The study was conducted as a pilot prospect i ve , multi-centre , community-based , r and omised wait-list controlled trial . Community-dwelling caregivers of persons with diagnosed dementia were r and omly assigned to a 12-week ( 14-hour ) TM training program or wait-list control . Participants were assessed for quality of life , stress , affect , cognitive performance and adverse effects . The feasibility of the study was also evaluated . Results Seventeen caregivers were recruited and r and omised .  Improvements in WebNeuro response speed scores over time were significantly ( p = 0.03 ) greater in the TM group relative to control . Changes between groups over time in all other primary and secondary outcome measures did not reach statistical significance . However , there was a trend toward greater improvement in WebNeuro stress , depression and negativity bias scores in the TM group . Adverse events were reported amongst 63 % of TM-treated subjects ; however , events were generally transient , of mild-moderate intensity and only ‘ possibly ’ related to TM . Conclusions Dementia caregivers exposed to TM demonstrated varying degrees of improvement in several measures of cognitive function , mood , quality of life and stress following exposure to TM . However , as the pilot study was underpowered , no firm conclusions can be made about the effectiveness of TM in this caregiver population . Findings from full-scale trials are now warranted . Trial registration Australian New Zeal and Clinical Trial Registry ACTRN12613000184774 ( Registered 15th February 2013 ) The emerging concept of psychobiotics — live microorganisms with a potential mental health benefit — represents a novel approach for the management of stress-related conditions . The majority of studies have focused on animal models . Recent pre clinical studies have identified the B. longum 1714 strain as a putative psychobiotic with an impact on stress-related behaviors , physiology and cognitive performance . Whether such pre clinical effects could be translated to healthy human volunteers remains unknown . We tested whether psychobiotic consumption could affect the stress response , cognition and brain activity patterns . In a within- participants design , healthy volunteers ( N=22 ) completed cognitive assessment s , resting electroencephalography and were exposed to a socially evaluated cold pressor test at baseline , post-placebo and post-psychobiotic . Increases in cortisol output and subjective anxiety in response to the socially evaluated cold pressor test were attenuated . Furthermore , daily reported stress was reduced by psychobiotic consumption . We also observed subtle improvements in hippocampus-dependent visuospatial memory performance , as well as enhanced frontal midline electroencephalographic mobility following psychobiotic consumption . These subtle but clear benefits are in line with the predicted impact from pre clinical screening platforms . Our results indicate that consumption of B. longum 1714 is associated with reduced stress and improved memory . Further studies are warranted to evaluate the benefits of this putative psychobiotic in relevant stress-related conditions and to unravel the mechanisms underlying such effects Familial  caregivers of patients with Alzheimer 's disease exhibit reduced quality of life and increased stress levels . The aim of this study was to investigate the effects of an 8-week yoga and compassion meditation program on the perceived stress , anxiety , depression , and salivary cortisol levels in familial caregivers . A total of 46 volunteers were r and omly assigned to participate in a stress-reduction program for a 2-month period ( yoga and compassion meditation program — YCMP group ) ( n = 25 ) or an untreated group for the same period of time ( control group ) ( n = 21 ) . The levels of stress , anxiety , depression , and morning salivary cortisol of the participants were measured before and after intervention . The groups were initially homogeneous ; however , after intervention , the groups diverged significantly . The YCMP group exhibited a reduction of the stress ( P < 0.05 ) , anxiety ( P < 0.000001 ) , and depression ( P < 0.00001 ) levels , as well as a reduction in the concentration of salivary cortisol ( P < 0.05 ) . Our study suggests that an 8-week yoga and compassion meditation program may offer an effective intervention for reducing perceived stress , anxiety , depression , and salivary cortisol in familial caregivers Rationale A visuospatial episodic memory impairment has recently been identified in irritable bowel syndrome . Increased tryptophan metabolism along the kynurenine pathway has also been reported in irritable bowel syndrome , which may play a role in altered cognitive performance as peripheral kynurenine can cross the blood brain barrier and lead to the production of neuroactive metabolites , which modulate glutamatergic and cholinergic signalling , key neurotransmitter systems involved in cognitive function . Objectives Utilising the acute tryptophan depletion ( ATD ) protocol , the aim of this study was to examine if manipulating peripheral levels of tryptophan regulates cognitive performance in irritable bowel syndrome and also to determine for the first time if the ATD protocol alters kynurenine supply to the central nervous system . Methods In this double-blind , placebo-controlled , crossover design study , nine female patients with irritable bowel syndrome and 14 matched female healthy controls participant completed a range 
    Output:
    