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: CONTEXT Even though the strong association between physical inactivity and ill health is well documented , 60 % of the population is inadequately active or completely inactive . Traditional methods of prescribing exercise have not proven effective for increasing and maintaining a program of regular physical activity . OBJECTIVE To compare the 24-month intervention effects of a lifestyle physical activity program with traditional structured exercise on improving physical activity , cardiorespiratory fitness , and cardiovascular disease risk factors . DESIGN R and omized clinical trial conducted from August 1 , 1993 , through July 31 , 1997 . PARTICIPANTS Sedentary men ( n = 116 ) and women ( n = 119 ) with self-reported physical activity of less than 36 and 34 kcal/kg per day , respectively . INTERVENTIONS Six months of intensive and 18 months of maintenance intervention on either a lifestyle physical activity or a traditional structured exercise program . MAIN OUTCOME MEASURES Primary outcomes were physical activity assessed by the 7-Day Physical Activity Recall and peak oxygen consumption ( VO2peak ) by a maximal exercise treadmill test . Secondary outcomes were plasma lipid and lipoprotein cholesterol concentrations , blood pressure , and body composition . All measures were obtained at baseline and at 6 and 24 months . RESULTS Both the lifestyle and structured activity groups had significant and comparable improvements in physical activity and cardiorespiratory fitness from baseline to 24 months . Adjusted mean changes ( 95 % confidence intervals [ CIs ] ) were 0.84 ( 95 % CI , 0.42 - 1.25 kcal/kg per day ; P<.001 ) and 0.69 ( 95 % CI , 0.25 - 1.12 kcal/kg day ; P = .002 ) for activity , and 0.77 ( 95 % CI , 0.18 - 1.36 mL/kg per minute ; P = .01 ) and 1.34 ( 95 % CI , 0.72 - 1.96 mL/kg per minute ; P<.001 ) for VO2peak for the lifestyle and structured activity groups , respectively . There were significant and comparable reductions in systolic blood pressure ( -3.63 [ 95 % CI , -5.54 to -1.72 mm Hg ; P<.001 ] and -3.26 [ 95 % CI , -5.26 to -1.25 mm Hg ; P = .002 ] ) and diastolic blood pressure ( -5.38 [ 95 % CI , -6.90 to -3.86 mm Hg ; P<.001 ] and -5.14 [ 95 % CI , -6.73 to -3.54 mm Hg ; P<.001 ) for the lifestyle and structured activity groups , respectively . Neither group significantly changed their weight ( -0.05 [ 95 % CI , -1.05 to 0.96 kg ; P = .93 ] and 0.69 [ 95 % CI , -0.37 to 1.74 kg ; P = .20 ] ) , but each group significantly reduced their percentage of body fat ( -2.39 % [ 95 % CI , -2.92 % to -1.85 % ; P<.001 ] and -1.85 % [ 95 % CI , -2.41 % to -1.28 % ; P<.001 ] ) in the lifestyle and structured activity groups , respectively . CONCLUSIONS In previously sedentary healthy adults , a lifestyle physical activity intervention is as effective as a structured exercise program in improving physical activity , cardiorespiratory fitness , and blood pressure Department of Health and Social Security . Report on confidential enquiries into maternal deaths in Engl and and Wales 1973 - 5 . London : HMSO , 1979 . ( Reports on health and social subjects No 14 . ) 2 Ministry of Health . Report on confidential enquiries into maternal deaths in Engl and and Wales 1961 - 3 . London : HMSO , 1966 . ( Reports on public health and medical subjects No 115 . ) 3 And erson JR . Too few necropsies . Br MedJ3 1979 ; ii : 932 . 4 Cameron HM , McGoogan E , Clark J , Wilson BA . Trends in hospital necropsy rates in Scotl and 1961 - 74 . Br MedJ 1977;i:1577 - 80 . 5 Editorial . Reviving the hospital necropsy . Br MedJ3 1977;i:1560 . 6 Sheehan HL . Post-partum necrosis of the anterior pituitary . 3rournal of Pathology and Bacteriology 1937;45:189 - 214 . 7 Robertson WB , Brosens I , Dixon HG . The pathological response of the vessels of the placental bed to hypertensive pregnancy . Journal of Pathology and Bacteriology 1967;93 : 581 - 92 . 8 Whittington RM , Robinson JS , Thompson JM . Fatal aspiration ( Mendelson 's ) syndrome despite antacids and cricoid pressure . Lancet 1979 ; ii : 228 - 30 . 9 Claireaux A. Stillbirths and first week deaths . In : British births 1970 . Vol I. The first week of life . London : Heinemann , 1975 . 10 McWeeny PM , Emery JL . Unexpected postnatal deaths ( cot deaths ) due to recognizable disease . Arch Dis Child 1975;50:191 - 6 AIM To describe experiences with and knowledge of minor illness  , self-care interventions used in minor illness and channels of information used when providing self-care for minor illness . BACKGROUND Although minor illness is self-limiting , symptoms can be substantial and have a great impact on the affected person 's wellbeing . Possibilities to seek and find information about health and self-care have significantly increased through internet-based communities , forums , and websites . Still , a considerable number of consultations with general practitioners are for conditions that are potentially self-treatable . Seeking advanced care for minor illnesses is costly for society and can create discomfort for patients as they are down-prioritized at emergency departments . METHODS Study participants were recruited r and omly from the Swedish Address Register . A question naire was sent out , and the final sample included 317 r and omly selected persons aged 18 - 80 and living in Sweden . FINDINGS Having experienced a specific illness correlated with self-reported knowledge . Preferred self-care interventions  differed between different conditions , but  resting and self-medicating  were commonly used , along with consulting health care facilities . Compliance to advice was the highest for official information channels , and family members were a popular source of advice Background Lifestyle-related diseases , including diabetes , cardiovascular disease , and some cancers represent the greatest global health threat . Greater insight into health needs and beliefs , using broad community sample s , is vital to reduce the burden of chronic disease . This study aim ed to investigate gender , age , screening practice s , health beliefs , and perceived future health needs for healthy ageing . Methods R and om probability sampling using self-completion surveys  in 1456 adults residing in Australia . Results Screening behaviors were associated with gender and age . Men and women > 51 years were more likely ( 27 % ) to have  screening health checks  than those < 50 years ( 2 % ) . Factors nominated to influence health were lifestyle ( 92 % ) , relationships ( 82 % ) , and environment ( 80 % ) . Women were more likely to nominate preparedness to have an annual health check , willingness to seek advice from their medical practitioner and to attend education sessions . Numerous health fears were associated with ageing , however participants were more likely to have a financial ( 72 % ) rather than a health plan ( 42 % ) . More women and participants > 51 years wanted information regarding illness prevention than men or those aged < 30 years . Conclusion Age and gender are associated with health related behaviors . Optimal health is perceived as a priority , yet often this perception is not translated into preventative action . These findings will inform future research and policy makers as we strive towards a healthier ageing society and the prevention of chronic disease This study compared Panic Online ( PO ) , an internet-based CBT intervention , to best- practice face-to-face CBT for people with panic disorder with or without agoraphobia . Eighty-six people with a primary diagnosis of panic disorder were recruited from Victoria , Australia . Participants were r and omly assigned to either PO ( n=46 ) or best practice face-to-face CBT ( n=40 ) . Effects of the internet-based CBT program were found to be comparable to those of face-to-face CBT . Both interventions produced significant reductions in panic disorder and agoraphobia clinician severity ratings , self reported panic disorder severity and panic attack frequency , measures of depression , anxiety , stress and panic related cognitions , and displayed improvements in quality of life . Participants rated both treatment conditions as equally credible and satisfying . Participants in the face-to-face CBT treatment group cited higher enjoyment with communicating with their therapist . Consistent with this , therapists ' ratings for compliance to treatment and underst and ing of the CBT material was higher in the face-to-face CBT treatment group . PO required significantly less therapist time than the face-to-face CBT condition The ability of a  medical self-care program  to have an impact on the utilization and cost of in-clinic and referral visits in a prepaid group practice was studied by following the medical encounter records of 900 HMO members in 217 families during a 12-month period . A control group selected by r and omization after acceptance of an initial invitation to participate was employed . In spite of the program 's impressive effect on both self-care knowledge and per-visit costs , the study could not demonstrate any significant program effect either on the frequency or on the total costs of clinic visits We conducted a trial to evaluate the impact of medical self-care education on 330 elders whose average age was 71 . The test group participated in a 13-session educational intervention with training in clinical medicine , life-style , and use of health services . The comparison group received a two-hour lecture-demonstration . Both groups were assessed pre-intervention , post-intervention , and one year after entry . The results indicate medical self-care instruction : produces substantial improvements , that were sustained for one year , in health knowledge , skills performance , and skills confidence ; stimulates many attempts to improve life-style ; and generates improvements in life quality . The program had little influence on utilization of medical care or health status This exploratory study was conducted to determine the effects of an educational program on the number and severity of premenstrual symptoms as well as the number of premenstrual days with symptoms .  Participants were a convenience sample of 47 employed women , whose scores on Abraham 's Menstrual Symptomatology Question naire were in the moderate to severe range . Women were r and omly divided into control and experimental groups , and those in the experimental groups participated in an education program . Both groups recorded daily on Abraham 's Menstrual Symptom Diary for 19 anxiety , appetite , edema , and depression symptoms . Participants in the education program had fewer occurrences of anxiety and appetite symptoms and fewer severe edema and depression symptoms , as well as fewer days with symptoms , than women who did not participate in the educational program . The findings support the idea that client education can promote self-care and improve health status BACKGROUND Most patient chronic disease  self-management interventions target single-disease outcomes . We evaluated the effect of a tailored hypertension self-management intervention on the unintended targets of glycosylated hemoglobin ( HbA1c ) and low-density lipoprotein cholesterol ( LDL-C ) . METHODS We evaluated patients from the Veterans Study to Improve the Control of Hypertension , a 2-year r and omized controlled trial . Patients received either a hypertension self-management intervention delivered by a nurse over the telephone or usual care . Although the study focused on hypertension self-management , we compared changes in HbA1c among a subgroup of 216 patients with diabetes and LDL-C among 528 patients with measurements during the study period . Changes in these laboratory values over time were compared between the 2 treatment groups using linear mixed-effects models . RESULTS For the patients with diabetes , the hypertension self-management intervention result ed in a 0.46 % reduction in HbA1c over 2 years compared with usual care ( 95 % confidence interval , 0.04%-0.89 % ; P = .03 ) . For LDL-C , there was a minimal 0.9 mg/dL between-group difference that was not statistically significant ( 95 % confidence interval , -7.3 - 5.6 mg/dL ; P = .79 ) . CONCLUSIONS There was a significant effect of the self-management intervention on the unintended target of HbA1c , but not LDL-C. Chronic disease self-management interventions might have " spill-over " effects on patients ' comorbid chronic conditions To determine the effect of a self-care communication-based health education program on ambulatory care utilization , a prospect i ve , r and omized , controlled trial was conducted with a Medicare population within a health maintenance organization . A statistically significant decrease of 15 % in total medical visits was found in the experimental group as compared with a control . Although not evident in the control , a statistically significant decrease in the ratio of follow-up visits from pre-entry to postentry was realized in the experimental group . Medical-visit decreases result ed in a savings of $ 
    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: CONTEXT Even though the strong association between physical inactivity and ill health is well documented , 60 % of the population is inadequately active or completely inactive . Traditional methods of prescribing exercise have not proven effective for increasing and maintaining a program of regular physical activity . OBJECTIVE To compare the 24-month intervention effects of a lifestyle physical activity program with traditional structured exercise on improving physical activity , cardiorespiratory fitness , and cardiovascular disease risk factors . DESIGN R and omized clinical trial conducted from August 1 , 1993 , through July 31 , 1997 . PARTICIPANTS Sedentary men ( n = 116 ) and women ( n = 119 ) with self-reported physical activity of less than 36 and 34 kcal/kg per day , respectively . INTERVENTIONS Six months of intensive and 18 months of maintenance intervention on either a lifestyle physical activity or a traditional structured exercise program . MAIN OUTCOME MEASURES Primary outcomes were physical activity assessed by the 7-Day Physical Activity Recall and peak oxygen consumption ( VO2peak ) by a maximal exercise treadmill test . Secondary outcomes were plasma lipid and lipoprotein cholesterol concentrations , blood pressure , and body composition . All measures were obtained at baseline and at 6 and 24 months . RESULTS Both the lifestyle and structured activity groups had significant and comparable improvements in physical activity and cardiorespiratory fitness from baseline to 24 months . Adjusted mean changes ( 95 % confidence intervals [ CIs ] ) were 0.84 ( 95 % CI , 0.42 - 1.25 kcal/kg per day ; P<.001 ) and 0.69 ( 95 % CI , 0.25 - 1.12 kcal/kg day ; P = .002 ) for activity , and 0.77 ( 95 % CI , 0.18 - 1.36 mL/kg per minute ; P = .01 ) and 1.34 ( 95 % CI , 0.72 - 1.96 mL/kg per minute ; P<.001 ) for VO2peak for the lifestyle and structured activity groups , respectively . There were significant and comparable reductions in systolic blood pressure ( -3.63 [ 95 % CI , -5.54 to -1.72 mm Hg ; P<.001 ] and -3.26 [ 95 % CI , -5.26 to -1.25 mm Hg ; P = .002 ] ) and diastolic blood pressure ( -5.38 [ 95 % CI , -6.90 to -3.86 mm Hg ; P<.001 ] and -5.14 [ 95 % CI , -6.73 to -3.54 mm Hg ; P<.001 ) for the lifestyle and structured activity groups , respectively . Neither group significantly changed their weight ( -0.05 [ 95 % CI , -1.05 to 0.96 kg ; P = .93 ] and 0.69 [ 95 % CI , -0.37 to 1.74 kg ; P = .20 ] ) , but each group significantly reduced their percentage of body fat ( -2.39 % [ 95 % CI , -2.92 % to -1.85 % ; P<.001 ] and -1.85 % [ 95 % CI , -2.41 % to -1.28 % ; P<.001 ] ) in the lifestyle and structured activity groups , respectively . CONCLUSIONS In previously sedentary healthy adults , a lifestyle physical activity intervention is as effective as a structured exercise program in improving physical activity , cardiorespiratory fitness , and blood pressure Department of Health and Social Security . Report on confidential enquiries into maternal deaths in Engl and and Wales 1973 - 5 . London : HMSO , 1979 . ( Reports on health and social subjects No 14 . ) 2 Ministry of Health . Report on confidential enquiries into maternal deaths in Engl and and Wales 1961 - 3 . London : HMSO , 1966 . ( Reports on public health and medical subjects No 115 . ) 3 And erson JR . Too few necropsies . Br MedJ3 1979 ; ii : 932 . 4 Cameron HM , McGoogan E , Clark J , Wilson BA . Trends in hospital necropsy rates in Scotl and 1961 - 74 . Br MedJ 1977;i:1577 - 80 . 5 Editorial . Reviving the hospital necropsy . Br MedJ3 1977;i:1560 . 6 Sheehan HL . Post-partum necrosis of the anterior pituitary . 3rournal of Pathology and Bacteriology 1937;45:189 - 214 . 7 Robertson WB , Brosens I , Dixon HG . The pathological response of the vessels of the placental bed to hypertensive pregnancy . Journal of Pathology and Bacteriology 1967;93 : 581 - 92 . 8 Whittington RM , Robinson JS , Thompson JM . Fatal aspiration ( Mendelson 's ) syndrome despite antacids and cricoid pressure . Lancet 1979 ; ii : 228 - 30 . 9 Claireaux A. Stillbirths and first week deaths . In : British births 1970 . Vol I. The first week of life . London : Heinemann , 1975 . 10 McWeeny PM , Emery JL . Unexpected postnatal deaths ( cot deaths ) due to recognizable disease . Arch Dis Child 1975;50:191 - 6 AIM To describe experiences with and knowledge of minor illness  , self-care interventions used in minor illness and channels of information used when providing self-care for minor illness . BACKGROUND Although minor illness is self-limiting , symptoms can be substantial and have a great impact on the affected person 's wellbeing . Possibilities to seek and find information about health and self-care have significantly increased through internet-based communities , forums , and websites . Still , a considerable number of consultations with general practitioners are for conditions that are potentially self-treatable . Seeking advanced care for minor illnesses is costly for society and can create discomfort for patients as they are down-prioritized at emergency departments . METHODS Study participants were recruited r and omly from the Swedish Address Register . A question naire was sent out , and the final sample included 317 r and omly selected persons aged 18 - 80 and living in Sweden . FINDINGS Having experienced a specific illness correlated with self-reported knowledge . Preferred self-care interventions  differed between different conditions , but  resting and self-medicating  were commonly used , along with consulting health care facilities . Compliance to advice was the highest for official information channels , and family members were a popular source of advice Background Lifestyle-related diseases , including diabetes , cardiovascular disease , and some cancers represent the greatest global health threat . Greater insight into health needs and beliefs , using broad community sample s , is vital to reduce the burden of chronic disease . This study aim ed to investigate gender , age , screening practice s , health beliefs , and perceived future health needs for healthy ageing . Methods R and om probability sampling using self-completion surveys  in 1456 adults residing in Australia . Results Screening behaviors were associated with gender and age . Men and women > 51 years were more likely ( 27 % ) to have  screening health checks  than those < 50 years ( 2 % ) . Factors nominated to influence health were lifestyle ( 92 % ) , relationships ( 82 % ) , and environment ( 80 % ) . Women were more likely to nominate preparedness to have an annual health check , willingness to seek advice from their medical practitioner and to attend education sessions . Numerous health fears were associated with ageing , however participants were more likely to have a financial ( 72 % ) rather than a health plan ( 42 % ) . More women and participants > 51 years wanted information regarding illness prevention than men or those aged < 30 years . Conclusion Age and gender are associated with health related behaviors . Optimal health is perceived as a priority , yet often this perception is not translated into preventative action . These findings will inform future research and policy makers as we strive towards a healthier ageing society and the prevention of chronic disease This study compared Panic Online ( PO ) , an internet-based CBT intervention , to best- practice face-to-face CBT for people with panic disorder with or without agoraphobia . Eighty-six people with a primary diagnosis of panic disorder were recruited from Victoria , Australia . Participants were r and omly assigned to either PO ( n=46 ) or best practice face-to-face CBT ( n=40 ) . Effects of the internet-based CBT program were found to be comparable to those of face-to-face CBT . Both interventions produced significant reductions in panic disorder and agoraphobia clinician severity ratings , self reported panic disorder severity and panic attack frequency , measures of depression , anxiety , stress and panic related cognitions , and displayed improvements in quality of life . Participants rated both treatment conditions as equally credible and satisfying . Participants in the face-to-face CBT treatment group cited higher enjoyment with communicating with their therapist . Consistent with this , therapists ' ratings for compliance to treatment and underst and ing of the CBT material was higher in the face-to-face CBT treatment group . PO required significantly less therapist time than the face-to-face CBT condition The ability of a  medical self-care program  to have an impact on the utilization and cost of in-clinic and referral visits in a prepaid group practice was studied by following the medical encounter records of 900 HMO members in 217 families during a 12-month period . A control group selected by r and omization after acceptance of an initial invitation to participate was employed . In spite of the program 's impressive effect on both self-care knowledge and per-visit costs , the study could not demonstrate any significant program effect either on the frequency or on the total costs of clinic visits We conducted a trial to evaluate the impact of medical self-care education on 330 elders whose average age was 71 . The test group participated in a 13-session educational intervention with training in clinical medicine , life-style , and use of health services . The comparison group received a two-hour lecture-demonstration . Both groups were assessed pre-intervention , post-intervention , and one year after entry . The results indicate medical self-care instruction : produces substantial improvements , that were sustained for one year , in health knowledge , skills performance , and skills confidence ; stimulates many attempts to improve life-style ; and generates improvements in life quality . The program had little influence on utilization of medical care or health status This exploratory study was conducted to determine the effects of an educational program on the number and severity of premenstrual symptoms as well as the number of premenstrual days with symptoms .  Participants were a convenience sample of 47 employed women , whose scores on Abraham 's Menstrual Symptomatology Question naire were in the moderate to severe range . Women were r and omly divided into control and experimental groups , and those in the experimental groups participated in an education program . Both groups recorded daily on Abraham 's Menstrual Symptom Diary for 19 anxiety , appetite , edema , and depression symptoms . Participants in the education program had fewer occurrences of anxiety and appetite symptoms and fewer severe edema and depression symptoms , as well as fewer days with symptoms , than women who did not participate in the educational program . The findings support the idea that client education can promote self-care and improve health status BACKGROUND Most patient chronic disease  self-management interventions target single-disease outcomes . We evaluated the effect of a tailored hypertension self-management intervention on the unintended targets of glycosylated hemoglobin ( HbA1c ) and low-density lipoprotein cholesterol ( LDL-C ) . METHODS We evaluated patients from the Veterans Study to Improve the Control of Hypertension , a 2-year r and omized controlled trial . Patients received either a hypertension self-management intervention delivered by a nurse over the telephone or usual care . Although the study focused on hypertension self-management , we compared changes in HbA1c among a subgroup of 216 patients with diabetes and LDL-C among 528 patients with measurements during the study period . Changes in these laboratory values over time were compared between the 2 treatment groups using linear mixed-effects models . RESULTS For the patients with diabetes , the hypertension self-management intervention result ed in a 0.46 % reduction in HbA1c over 2 years compared with usual care ( 95 % confidence interval , 0.04%-0.89 % ; P = .03 ) . For LDL-C , there was a minimal 0.9 mg/dL between-group difference that was not statistically significant ( 95 % confidence interval , -7.3 - 5.6 mg/dL ; P = .79 ) . CONCLUSIONS There was a significant effect of the self-management intervention on the unintended target of HbA1c , but not LDL-C. Chronic disease self-management interventions might have " spill-over " effects on patients ' comorbid chronic conditions To determine the effect of a self-care communication-based health education program on ambulatory care utilization , a prospect i ve , r and omized , controlled trial was conducted with a Medicare population within a health maintenance organization . A statistically significant decrease of 15 % in total medical visits was found in the experimental group as compared with a control . Although not evident in the control , a statistically significant decrease in the ratio of follow-up visits from pre-entry to postentry was realized in the experimental group . Medical-visit decreases result ed in a savings of $ 
    Output:
    