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: AIM This paper reports a study to examine the effectiveness of a 6-month dementia care programme for Chinese families living with and caring for a relative with dementia , compared with routine family support services in Hong Kong . BACKGROUND Recognizing the adverse psychosocial health effects inherent in dementia care , different psychosocial interventions provided preliminary evidence of their effectiveness in improving family members ' knowledge and skills in caregiving and delaying dementia sufferers ' illness deterioration and institutionalization . Little is known about the effects of such interventions for family caregivers ' psychosocial health conditions , particularly in non-Western population s. METHODS A r and omized controlled trial was conducted with 92 Chinese families of a relative with dementia in two dementia care centres in Hong Kong . They were r and omly selected from a dementia client list and then r and omly assigned to receive either the dementia family care programme ( n=46 ) , or routine care only ( n=46 ) . Clients ' symptoms and institutionalization , and caregivers ' quality of life , burden and social support at recruitment , 1 week , and 12 and 18 months following intervention were measured and compared between the study groups using repeated measures MANOVAS followed by Helmert 's contrast tests . Data was collected over a period of 24 months , between September 2007 and August 2009 . RESULTS Results of the MANOVAS and contrast tests indicated that at 18-month follow-up , participants in the family programme reported significantly greater improvements in clients ' symptoms and institutionalization rates , and caregivers ' quality of life and burden , when compared with their counterparts in the routine care group . CONCLUSION These findings provide evidence that the dementia care family programme can improve the psychosocial functioning of both clients with dementia and their family caregivers in a Chinese population . Further research is recommended to investigate whether this intervention can also apply to families with different socio-economic background s and across cultures BACKGROUND Based on the National Institute on Aging/National Institute of Nursing Research Re sources for Enhancing Alzheimer 's Caregiver Health ( REACH ) r and omized controlled trial ( REACH II ) , REACH VA ( Department of Veterans Affairs ) was the first national clinical translation of a proven behavioral intervention for dementia caregivers , running from September 2007 through August 2009 . This article describes the population and outcomes of the REACH VA translation of REACH II into the VA . METHODS Clinical staff members from 24 VA Medical Center Home-Based Primary Care programs in 15 states delivered the intervention to stressed caregivers of patients with dementia . Like REACH II , the 6-month REACH VA intervention , structured through a protocol and individualized through a risk assessment , targeted education , support , and skills training to address caregiving risk areas of safety , social support , problem behaviors , depression , and health through 12 individual in-home and telephone sessions and 5 telephone support group sessions . Staff members of the Memphis VA Medical Center , Memphis , Tennessee , collected data on burden , depression , health and healthy behaviors , caregiving frustrations , social support , dementia-related behaviors , and time spent providing care and on duty . RESULTS From baseline to 6 months , caregivers reported significantly decreased burden , depression , impact of depression on daily life , caregiving frustrations , and number of troubling dementia-related behaviors . A 2-hour decrease in hours per day on duty approached significance . Caregivers ( 96 % ) believed that the program should be provided by the VA to caregivers . CONCLUSIONS This clinical translation achieved outcomes similar to the REACH II r and omized controlled trial , providing clinical ly significant benefits for caregivers of a veteran with a progressive dementing disease . This model of caregiver support can inform public policy in providing assistance to caregivers 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 Purpose Many family caregivers of persons with dementia ( PWD ) are unable to participate in community center-based caregiver support services because of logistical constraints . This study evaluated the effectiveness of a telephone-delivered psychoeducational intervention for family caregivers of PWD in alleviating caregiver burden and enhancing caregiving self-efficacy . Subjects and methods In a single-blinded r and omized controlled trial , 38 family caregivers of PWD were r and omly allocated into an intervention group or a control group . The intervention group received psychoeducation from a registered social worker over the phone for 12 sessions . Caregivers in the control group were given a DVD containing educational information about dementia caregiving . Outcomes of the intervention were measured by the Chinese versions of the Zarit Burden Interview and the Revised Scale for Caregiving Self-efficacy . Mann – Whitney U tests were used to compare the differences between the intervention and control groups . Results The level of burden of caregivers in the intervention group reduced significantly compared with caregivers in the control group . Caregivers in the intervention group also reported significantly more gain in self-efficacy in obtaining respite than the control group . Conclusion A structured telephone intervention can benefit dementia caregivers in terms of self-efficacy and caregiving burden . The limitations of the research and recommendations for intervention are discussed OBJECTIVES Dementia is a rapidly growing public health problem in low and middle income countries . There is an urgent need , in the absence of formal services , to develop interventions design ed to improve the lives of people with dementia , and their families . This study tests the effectiveness of the 10/66 caregiver intervention among people with dementia , and their carers . DESIGN A single blind parallel group r and omized controlled trial ( IS RCT N41039907 ) . SETTING Moscow . PARTICIPANTS Sixty family caregivers of people aged 65 and over with dementia were r and omized to receive the intervention and medical care as usual ( n = 30 ) or medical care as usual only ( n = 30 ) . Caregiver and person with dementia outcomes were assessed at baseline and after 6 months . INTERVENTION The caregiver education and training intervention was delivered over five , weekly , half-hour sessions and was made up of three modules : ( i ) assessment ( one session ) ; ( ii ) basic education about dementia ( two sessions ) ; and ( iii ) training regarding specific problem behaviors ( two sessions ) . MEASUREMENTS Dementia was diagnosed using DSM-IV criteria . Caregiver : Zarit Carer Burden Interview ; carer psychological distress ( SRQ 20 ) ; and carer Quality of Life ( WHOQOL-BREF ) . Person with dementia : Behavioural and Psychological symptoms ( NPI-Q ) ; quality of life ( DEMQOL ) . RESULTS Caregivers in the intervention group reported large and statistically significant net improvements at 6-month follow-up in burden compared to controls . No group differences were found on caregiver psychological distress and patient and caregiver quality of life . CONCLUSIONS The low-level intervention seems to be as , if not more , effective than similar interventions applied in high income countries Objectives To develop and evaluate the effectiveness of a home based intervention in reducing caregiver burden , promoting caregiver mental health and reducing behavioural problems in elderly persons with dementia . Methodology and Principal Findings This was a r and omised controlled trial in which the person with dementia-caregiver dyad was r and omly allocated either to receive the intervention immediately or to a waiting list group which received the intervention after 6 months . It was carried out in communities based in two talukas ( administrative blocks ) in Goa , India . Mild to moderate cases with dementia ( diagnosed using the DSM IV criteria and grade d using the Clinical Dementia Rating scale ) and their caregivers were included in the trial . Community based intervention provided by a team consisting of Home Care Advisors who were supervised by a counselor and a psychiatrist , focusing on supporting the caregiver through information on dementia , guidance on behaviour management , a single psychiatric assessment and psychotropic medication if needed . We measured caregiver mental health ( General Health Question naire ) , caregiver burden ( Zarit Burden Score ) , distress due to behavioural disturbances ( NPI-D ) , behavioural problems in the subject ( NPI-S ) and activities of daily living in the elder with dementia ( EASI ) . Outcome evaluations were masked to the allocation status . We analysed each outcome with a mixed effects model . 81 families enrolled in the trial ; 41 were r and omly allocated to the intervention . 59 completed the trial and 18 died during the trial . The intervention led to a significant reduction of GHQ ( −1.12 , 95 % CI −2.07 to −0.17 ) and NPI-D scores ( −1.96 , 95%CI −3.51 to −0.41 ) and non-significant reductions in the ZBS , EASI and NPI-S scores . We also observed a non-significant reduction in the total number of deaths in people with dementia in the intervention arm ( OR 0.34 , 95 % CI 0.01 to 1.03 ) . Conclusion Home based support for caregivers of persons with dementia , which emphasizes the use of locally available , low-cost human re sources , is feasible , acceptable and leads to significant improvements in caregiver mental health and burden of caring . Clinical Trials.gov Among the diverse group of interventions developed to help dementia family caregivers  cognitive-behavioural approaches show especially promising results . Objectives : This study describes a cognitive-behavioural group intervention aim ed principally at the modification of dysfunctional thoughts associated with caregiving ( MDTC ) . The efficacy of the MDTC intervention in reducing caregivers ’ depressive symptomatology , together with the frequency and appraisal of problem behaviours , is compared to that of a waiting-list control group ( WL ) . Furthermore , the potential mediating role of the dysfunctional thoughts in the relationship between this intervention and caregivers ’ depressive symptomatology is analyzed . Of the 74 dementia caregivers who were r and omized to one of two conditions ( MDTC and WL ) , 39 completed the post-intervention assessment . Statistical analyses were performed on an intention-to-treat basis , using last observation carried forward . The results reveal that the MDTC intervention is successful in reducing  caregivers ’ level of depressive symptomatology and dysfunctional thoughts about caregiving , as well as in modifying their appraisal of their relative 's problem behaviours . Furthermore , a mediating role for dysfunctional thoughts was found in the relationship between the MDTC intervention and levels of depressive symptomatology . The relevance of addressing dysfunctional thoughts and cognitive distortions in group interventions with caregivers is highlighted Objective To evaluate the effectiveness of a voluntary sector based befriending scheme in improving psychological wellbeing and quality of life for family carers of people with dementia . Design Single blind r and omised controlled trial . Setting Community setting s in East Anglia and London . Participants 236 family carers of people with primary progressive dementia . Intervention Contact with a befriender facilitator and offer of match with a trained lay volunteer befriender compared with no befriender facilitator contact ; all participants continued to receive “ usual care . ” Main outcome measures Carers ’ mood ( hospital anxiety and depression scale — depression ) and health related quality of life ( EuroQoL ) at 15 months post-r and omisation . Results The intention to treat analysis showed no benefit for the intervention “ access to a befriender facilitator ” on the primary outcome measure or on any of the secondary outcome measures . Conclusions In common with many carers ’ services , befriending schemes are not taken up by all carers , and providing access to a befriending scheme is not effective in improving wellbeing . Trial registration Current Controlled Trials IS RCT N08130075 Background Family caregivers of dementia patients are at increased risk of developing depression or anxiety . A multi-component program design ed to mobilize support of family networks demonstrated effectiveness in decreasing depressive symptoms in caregivers . However , the impact of an intervention consisting solely of family meetings on depression and anxiety has not yet been evaluated . This study examines the preventive effects of family meetings for primary caregivers of community-dwelling dementia patients . Methods A r and omized multicenter trial was conducted among 192 primary caregivers of community dwelling dementia patients . Caregivers did not meet the diagnostic criteria for depressive or anxiety disorder at baseline . Participants were r and omized to the family meetings intervention ( n = 96 ) or usual care ( n = 96 ) condition . The intervention consisted of two individual sessions and four family meetings which occurred once every 2 to 3 months for a year . Outcome measures after 12 months were the incidence of a clinical depressive or anxiety disorder and change in depressive and anxiety symptoms ( primary outcomes ) , caregiver burden and quality of life ( secondary outcomes ) . Intention-to-treat as well as per protocol analyses were performed . Results A substantial number of caregivers ( 72/192 ) developed a depressive or anxiety disorder within 12 months . The intervention was not superior to usual care either in reducing the 
    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: AIM This paper reports a study to examine the effectiveness of a 6-month dementia care programme for Chinese families living with and caring for a relative with dementia , compared with routine family support services in Hong Kong . BACKGROUND Recognizing the adverse psychosocial health effects inherent in dementia care , different psychosocial interventions provided preliminary evidence of their effectiveness in improving family members ' knowledge and skills in caregiving and delaying dementia sufferers ' illness deterioration and institutionalization . Little is known about the effects of such interventions for family caregivers ' psychosocial health conditions , particularly in non-Western population s. METHODS A r and omized controlled trial was conducted with 92 Chinese families of a relative with dementia in two dementia care centres in Hong Kong . They were r and omly selected from a dementia client list and then r and omly assigned to receive either the dementia family care programme ( n=46 ) , or routine care only ( n=46 ) . Clients ' symptoms and institutionalization , and caregivers ' quality of life , burden and social support at recruitment , 1 week , and 12 and 18 months following intervention were measured and compared between the study groups using repeated measures MANOVAS followed by Helmert 's contrast tests . Data was collected over a period of 24 months , between September 2007 and August 2009 . RESULTS Results of the MANOVAS and contrast tests indicated that at 18-month follow-up , participants in the family programme reported significantly greater improvements in clients ' symptoms and institutionalization rates , and caregivers ' quality of life and burden , when compared with their counterparts in the routine care group . CONCLUSION These findings provide evidence that the dementia care family programme can improve the psychosocial functioning of both clients with dementia and their family caregivers in a Chinese population . Further research is recommended to investigate whether this intervention can also apply to families with different socio-economic background s and across cultures BACKGROUND Based on the National Institute on Aging/National Institute of Nursing Research Re sources for Enhancing Alzheimer 's Caregiver Health ( REACH ) r and omized controlled trial ( REACH II ) , REACH VA ( Department of Veterans Affairs ) was the first national clinical translation of a proven behavioral intervention for dementia caregivers , running from September 2007 through August 2009 . This article describes the population and outcomes of the REACH VA translation of REACH II into the VA . METHODS Clinical staff members from 24 VA Medical Center Home-Based Primary Care programs in 15 states delivered the intervention to stressed caregivers of patients with dementia . Like REACH II , the 6-month REACH VA intervention , structured through a protocol and individualized through a risk assessment , targeted education , support , and skills training to address caregiving risk areas of safety , social support , problem behaviors , depression , and health through 12 individual in-home and telephone sessions and 5 telephone support group sessions . Staff members of the Memphis VA Medical Center , Memphis , Tennessee , collected data on burden , depression , health and healthy behaviors , caregiving frustrations , social support , dementia-related behaviors , and time spent providing care and on duty . RESULTS From baseline to 6 months , caregivers reported significantly decreased burden , depression , impact of depression on daily life , caregiving frustrations , and number of troubling dementia-related behaviors . A 2-hour decrease in hours per day on duty approached significance . Caregivers ( 96 % ) believed that the program should be provided by the VA to caregivers . CONCLUSIONS This clinical translation achieved outcomes similar to the REACH II r and omized controlled trial , providing clinical ly significant benefits for caregivers of a veteran with a progressive dementing disease . This model of caregiver support can inform public policy in providing assistance to caregivers 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 Purpose Many family caregivers of persons with dementia ( PWD ) are unable to participate in community center-based caregiver support services because of logistical constraints . This study evaluated the effectiveness of a telephone-delivered psychoeducational intervention for family caregivers of PWD in alleviating caregiver burden and enhancing caregiving self-efficacy . Subjects and methods In a single-blinded r and omized controlled trial , 38 family caregivers of PWD were r and omly allocated into an intervention group or a control group . The intervention group received psychoeducation from a registered social worker over the phone for 12 sessions . Caregivers in the control group were given a DVD containing educational information about dementia caregiving . Outcomes of the intervention were measured by the Chinese versions of the Zarit Burden Interview and the Revised Scale for Caregiving Self-efficacy . Mann – Whitney U tests were used to compare the differences between the intervention and control groups . Results The level of burden of caregivers in the intervention group reduced significantly compared with caregivers in the control group . Caregivers in the intervention group also reported significantly more gain in self-efficacy in obtaining respite than the control group . Conclusion A structured telephone intervention can benefit dementia caregivers in terms of self-efficacy and caregiving burden . The limitations of the research and recommendations for intervention are discussed OBJECTIVES Dementia is a rapidly growing public health problem in low and middle income countries . There is an urgent need , in the absence of formal services , to develop interventions design ed to improve the lives of people with dementia , and their families . This study tests the effectiveness of the 10/66 caregiver intervention among people with dementia , and their carers . DESIGN A single blind parallel group r and omized controlled trial ( IS RCT N41039907 ) . SETTING Moscow . PARTICIPANTS Sixty family caregivers of people aged 65 and over with dementia were r and omized to receive the intervention and medical care as usual ( n = 30 ) or medical care as usual only ( n = 30 ) . Caregiver and person with dementia outcomes were assessed at baseline and after 6 months . INTERVENTION The caregiver education and training intervention was delivered over five , weekly , half-hour sessions and was made up of three modules : ( i ) assessment ( one session ) ; ( ii ) basic education about dementia ( two sessions ) ; and ( iii ) training regarding specific problem behaviors ( two sessions ) . MEASUREMENTS Dementia was diagnosed using DSM-IV criteria . Caregiver : Zarit Carer Burden Interview ; carer psychological distress ( SRQ 20 ) ; and carer Quality of Life ( WHOQOL-BREF ) . Person with dementia : Behavioural and Psychological symptoms ( NPI-Q ) ; quality of life ( DEMQOL ) . RESULTS Caregivers in the intervention group reported large and statistically significant net improvements at 6-month follow-up in burden compared to controls . No group differences were found on caregiver psychological distress and patient and caregiver quality of life . CONCLUSIONS The low-level intervention seems to be as , if not more , effective than similar interventions applied in high income countries Objectives To develop and evaluate the effectiveness of a home based intervention in reducing caregiver burden , promoting caregiver mental health and reducing behavioural problems in elderly persons with dementia . Methodology and Principal Findings This was a r and omised controlled trial in which the person with dementia-caregiver dyad was r and omly allocated either to receive the intervention immediately or to a waiting list group which received the intervention after 6 months . It was carried out in communities based in two talukas ( administrative blocks ) in Goa , India . Mild to moderate cases with dementia ( diagnosed using the DSM IV criteria and grade d using the Clinical Dementia Rating scale ) and their caregivers were included in the trial . Community based intervention provided by a team consisting of Home Care Advisors who were supervised by a counselor and a psychiatrist , focusing on supporting the caregiver through information on dementia , guidance on behaviour management , a single psychiatric assessment and psychotropic medication if needed . We measured caregiver mental health ( General Health Question naire ) , caregiver burden ( Zarit Burden Score ) , distress due to behavioural disturbances ( NPI-D ) , behavioural problems in the subject ( NPI-S ) and activities of daily living in the elder with dementia ( EASI ) . Outcome evaluations were masked to the allocation status . We analysed each outcome with a mixed effects model . 81 families enrolled in the trial ; 41 were r and omly allocated to the intervention . 59 completed the trial and 18 died during the trial . The intervention led to a significant reduction of GHQ ( −1.12 , 95 % CI −2.07 to −0.17 ) and NPI-D scores ( −1.96 , 95%CI −3.51 to −0.41 ) and non-significant reductions in the ZBS , EASI and NPI-S scores . We also observed a non-significant reduction in the total number of deaths in people with dementia in the intervention arm ( OR 0.34 , 95 % CI 0.01 to 1.03 ) . Conclusion Home based support for caregivers of persons with dementia , which emphasizes the use of locally available , low-cost human re sources , is feasible , acceptable and leads to significant improvements in caregiver mental health and burden of caring . Clinical Trials.gov Among the diverse group of interventions developed to help dementia family caregivers  cognitive-behavioural approaches show especially promising results . Objectives : This study describes a cognitive-behavioural group intervention aim ed principally at the modification of dysfunctional thoughts associated with caregiving ( MDTC ) . The efficacy of the MDTC intervention in reducing caregivers ’ depressive symptomatology , together with the frequency and appraisal of problem behaviours , is compared to that of a waiting-list control group ( WL ) . Furthermore , the potential mediating role of the dysfunctional thoughts in the relationship between this intervention and caregivers ’ depressive symptomatology is analyzed . Of the 74 dementia caregivers who were r and omized to one of two conditions ( MDTC and WL ) , 39 completed the post-intervention assessment . Statistical analyses were performed on an intention-to-treat basis , using last observation carried forward . The results reveal that the MDTC intervention is successful in reducing  caregivers ’ level of depressive symptomatology and dysfunctional thoughts about caregiving , as well as in modifying their appraisal of their relative 's problem behaviours . Furthermore , a mediating role for dysfunctional thoughts was found in the relationship between the MDTC intervention and levels of depressive symptomatology . The relevance of addressing dysfunctional thoughts and cognitive distortions in group interventions with caregivers is highlighted Objective To evaluate the effectiveness of a voluntary sector based befriending scheme in improving psychological wellbeing and quality of life for family carers of people with dementia . Design Single blind r and omised controlled trial . Setting Community setting s in East Anglia and London . Participants 236 family carers of people with primary progressive dementia . Intervention Contact with a befriender facilitator and offer of match with a trained lay volunteer befriender compared with no befriender facilitator contact ; all participants continued to receive “ usual care . ” Main outcome measures Carers ’ mood ( hospital anxiety and depression scale — depression ) and health related quality of life ( EuroQoL ) at 15 months post-r and omisation . Results The intention to treat analysis showed no benefit for the intervention “ access to a befriender facilitator ” on the primary outcome measure or on any of the secondary outcome measures . Conclusions In common with many carers ’ services , befriending schemes are not taken up by all carers , and providing access to a befriending scheme is not effective in improving wellbeing . Trial registration Current Controlled Trials IS RCT N08130075 Background Family caregivers of dementia patients are at increased risk of developing depression or anxiety . A multi-component program design ed to mobilize support of family networks demonstrated effectiveness in decreasing depressive symptoms in caregivers . However , the impact of an intervention consisting solely of family meetings on depression and anxiety has not yet been evaluated . This study examines the preventive effects of family meetings for primary caregivers of community-dwelling dementia patients . Methods A r and omized multicenter trial was conducted among 192 primary caregivers of community dwelling dementia patients . Caregivers did not meet the diagnostic criteria for depressive or anxiety disorder at baseline . Participants were r and omized to the family meetings intervention ( n = 96 ) or usual care ( n = 96 ) condition . The intervention consisted of two individual sessions and four family meetings which occurred once every 2 to 3 months for a year . Outcome measures after 12 months were the incidence of a clinical depressive or anxiety disorder and change in depressive and anxiety symptoms ( primary outcomes ) , caregiver burden and quality of life ( secondary outcomes ) . Intention-to-treat as well as per protocol analyses were performed . Results A substantial number of caregivers ( 72/192 ) developed a depressive or anxiety disorder within 12 months . The intervention was not superior to usual care either in reducing the 
    Output:
    