***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 examine the prevalence of outcome reporting bias — the selection for publication of a subset of the original recorded outcome variables on the basis of the results — and its impact on Cochrane review s. Design A nine point classification system for missing outcome data in r and omised trials was developed and applied to the trials assessed in a large , unselected cohort of Cochrane systematic review s. Research ers who conducted the trials were contacted and the reason sought for the non-reporting of data . A sensitivity analysis was undertaken to assess the impact of outcome reporting bias on review s that included a single meta- analysis of the review primary outcome . Results More than half ( 157/283 ( 55 % ) ) the review s did not include full data for the review primary outcome of interest from all eligible trials . The median amount of review outcome data missing for any reason was 10 % , whereas 50 % or more of the potential data were missing in 70 ( 25 % ) review s. It was clear from the publications for 155 ( 6 % ) of the 2486 assessable trials that the research ers had measured and analysed the review primary outcome but did not report or only partially reported the results . For reports that did not mention the review primary outcome , our classification regarding the presence of outcome reporting bias was shown to have a sensitivity of 88 % ( 95 % CI 65 % to 100 % ) and specificity of 80 % ( 95 % CI 69 % to 90 % ) on the basis of responses from 62 trialists . A third of Cochrane review s ( 96/283 ( 34 % ) ) contained at least one trial with high suspicion of outcome reporting bias for the review primary outcome . In a sensitivity analysis undertaken for 81 review s with a single meta- analysis of the primary outcome of interest , the treatment effect estimate was reduced by 20 % or more in 19 ( 23 % ) . Of the 42 meta-analyses with a statistically significant result only , eight ( 19 % ) became non-significant after adjustment for outcome reporting bias and 11 ( 26 % ) would have overestimated the treatment effect by 20 % or more . Conclusions Outcome reporting bias is an under-recognised problem that affects the conclusions in a substantial proportion of Cochrane review s. Individuals conducting systematic review s need to address explicitly the issue of missing outcome data for their review to be considered a reliable source of evidence . Extra care is required during data extraction , review ers should identify when a trial reports that an outcome was measured but no results were reported or events observed , and contact with trialists should be encouraged Objective To develop and vali date a new diabetes risk algorithm ( the QDScore ) for estimating 10 year risk of acquiring diagnosed type 2 diabetes  over a 10 year time period in an ethnically and socioeconomically diverse population . Design Prospect i ve open cohort study using routinely collected data from 355 general practice s in Engl and and Wales to develop the score and from 176 separate practice s to vali date the score . Participants 2 540 753 patients aged 25 - 79 in the derivation cohort , who contributed 16 436 135 person years of observation and of whom 78 081 had an incident diagnosis of type 2 diabetes ; 1 232 832 patients ( 7 643 037 person years ) in the validation cohort , with 37 535 incident cases of type 2 diabetes . Outcome measures A Cox proportional hazards model was used to estimate effects of risk factors in the derivation cohort and to derive a risk equation in men and women . The predictive variables examined and included in the final model were self assigned ethnicity , age , sex , body mass index , smoking status , family history of diabetes , Townsend deprivation score , treated hypertension , cardiovascular disease , and current use of corticosteroids ; the outcome of interest was incident diabetes recorded in general practice records . Measures of calibration and discrimination were calculated in the validation cohort . Results A fourfold to fivefold variation in risk of type 2 diabetes existed between different ethnic groups . Compared with the white reference group , the adjusted hazard ratio was 4.07 ( 95 % confidence interval 3.24 to 5.11 ) for Bangladeshi women , 4.53 ( 3.67 to 5.59 ) for Bangladeshi men , 2.15 ( 1.84 to 2.52 ) for Pakistani women , and 2.54 ( 2.20 to 2.93 ) for Pakistani men . Pakistani and Bangladeshi men had significantly higher hazard ratios than Indian men . Black African men and Chinese women had an increased risk compared with the corresponding white reference group . In the validation data set , the model explained 51.53 % ( 95 % confidence interval 50.90 to 52.16 ) of the variation in women and 48.16 % ( 47.52 to 48.80 ) of that in men . The risk score showed good discrimination , with a D statistic of 2.11 ( 95 % confidence interval 2.08 to 2.14 ) in women and 1.97 ( 1.95 to 2.00 ) in men . The model was well calibrated . Conclusions The QDScore is the first risk prediction algorithm to estimate the 10 year risk of diabetes on the basis of a prospect i ve cohort study and including both social deprivation and ethnicity . The algorithm does not need laboratory tests and can be used in clinical setting s and also by the public through a simple web calculator ( www.qdscore.org ) Patients in a low-income community health center with Type 2 diabetes ( N = 81 ) taking a one-day education workshop  as part of their diabetes medical management were r and omly assigned either to education alone or to a combination of education and acceptance and commitment therapy ( ACT ) . Both groups were taught how to manage their diabetes , but those in the ACT condition also learned to apply acceptance and mindfulness skills to difficult diabetes-related thoughts and feelings . Compared with patients who received education alone , after 3 months those in the ACT condition were more likely to use these coping strategies , to report better diabetes self-care , and to have glycated hemoglobin ( HbA-sub(1C ) ) values in the target range . Mediational analyses indicated that changes in acceptance coping and self-management behavior mediated the impact of treatment on changes in HbA-sub(1C ) OBJECTIVE Depression is a common comorbidity of diabetes , undesirably affecting patients ’ physical and mental functioning . Psychological interventions are effective treatments for depression in the general population as well as in patients with a chronic disease . The aim of this study was to assess the efficacy of individual mindfulness-based cognitive therapy ( MBCT ) and individual cognitive behavior therapy ( CBT ) in comparison with a waiting-list control condition for treating depressive symptoms in adults with type 1 or type 2 diabetes . RESEARCH DESIGN AND METHODS In this r and omized controlled trial , 94 out patients with diabetes and comorbid depressive symptoms ( i.e. , Beck Depression Inventory-II [ BDI-II ] ≥14 ) were r and omized to MBCT ( n = 31 ) , CBT ( n = 32 ) , or waiting list ( n = 31 ) . All participants completed written question naires and interviews at pre- and postmeasurement ( 3 months later ) . Primary outcome measure was severity of depressive symptoms ( BDI-II and Toronto Hamilton Depression Rating Scale ) . Anxiety ( Generalized Anxiety Disorder 7 ) , well-being ( Well-Being Index ) , diabetes-related distress ( Problem Areas In Diabetes ) , and HbA1c levels were assessed as secondary outcomes . RESULTS Results showed that participants receiving MBCT and CBT reported significantly greater reductions in depressive symptoms compared with patients in the waiting-list control condition ( respectively , P = 0.004 and P < 0.001 ; d = 0.80 and 1.00 ; clinical ly relevant improvement 26 % and 29 % vs. 4 % ) . Both interventions also had significant positive effects on anxiety , well-being , and diabetes-related distress . No significant effect was found on HbA1c values . CONCLUSIONS Both individual MBCT and CBT are effective in improving a range of psychological symptoms in individuals with type 1 and type 2 diabetes Research on mindfulness-based interventions ( MBIs ) for treating symptoms of a wide range of medical conditions has proliferated in recent decades . Mindfulness is the cultivation of nonjudgmental awareness in the present moment . It is both a practice and a way of being in the world . Mindfulness is purpose fully cultivated in a range of structured interventions , the most popular of which is mindfulness-based stress reduction ( MBSR ) , followed by mindfulness-based cognitive therapy ( MBCT ) . This paper begins with a discussion of the phenomenological experience of coping with a chronic and potentially life-threatening illness , followed by a theoretical discussion of the application of mindfulness in these situations . The literature evaluating MBIs within medical conditions is then comprehensively review ed , applying a levels of evidence rating framework within each major condition . The bulk of the research looked at diagnoses of cancer , pain conditions ( chronic pain , low back pain , fibromyalgia , and rheumatoid arthritis ) , cardiovascular disease , diabetes , human immunodeficiency virus (HIV)/acquired immune deficiency syndrome ( AIDS ) , and irritable bowel syndrome . Most outcomes assessed are psychological in nature and show substantial benefit , although some physical and disease-related parameters have also been evaluated . The field would benefit from more adequately powered r and omized controlled trials utilizing active comparison groups and assessing the moderating role of patient characteristics and program “ dose ” in determining outcomes Mindfulness-based interventions can successfully target negative perseverative cognitions such as worry and thought suppression , but their acceptability and effectiveness in people with long-term conditions is uncertain . We therefore pilot tested a six-week meditation and mindfulness intervention in people ( n = 40 ) with diabetes mellitus and coronary heart disease . We used a sequential mixed- methods approach that measured change in worry and thought suppression and qualitatively explored acceptability , feasibility , and user experience with a focus group ( n = 11 ) and in-depth interviews ( n = 16 ) . The intervention was highly acceptable , with 90 % completing ≥5 sessions  . Meditation and mindfulness skills led to improved sleep , greater relaxation , and more-accepting approaches to illness and illness experience . At the end of the six-week meditation course , worry , and thought suppression were significantly reduced . Positive impacts of mindfulness-based interventions on psychological health may relate to acquisition and development of meta-cognitive skills but this needs experimental confirmation CONTEXT Psychological distress is linked with impaired glycemic control among diabetics . OBJECTIVE Estimate changes in glycemic control , weight , blood pressure , and stress-related psychological symptoms in patients with type 2 diabetes participating in a st and ard Mindfulness Based Stress Reduction ( MBSR ) program . DESIGN Prospect i ve , observational study . SETTING Academic health center . PATIENTS Adult patients with type 2 diabetes mellitus . INTERVENTIONS Participation in MBSR program for heterogeneous patient population . Diet and exercise regimens held constant . MAIN OUTCOME MEASURES Glycosylated hemoglobin A1c ( HA1c ) , blood pressure , body weight , and Symptom Checklist 90-Revised ( anxiety , depression , somatization , and general psychological distress scores ) . RESULTS Eleven of 14 patients completed the intervention . At 1 month follow-up , HA1c was reduced by 0.48 % ( P = .03 ) , and mean arterial pressure was reduced by 6 mmHg ( P = .009 ) . Body weight did not change . A decrease in measures of depression , anxiety , and general psychological distress was observed OBJECTIVE The DiaMind trial showed beneficial immediate effects of mindfulness-based cognitive therapy ( MBCT ) on emotional distress , but not on diabetes distress and HbA1c . The aim of the present report was to examine if the effects would be sustained after six month follow-up . METHODS In the DiaMind trial , 139 out patients with diabetes ( type-I or type-II ) and a lowered level of emotional well-being were r and omized into MBCT ( n=70 ) or a waiting list with treatment as usual ( TAU : n=69 ) . Primary outcomes were perceived stress , anxiety and depressive symptoms , and diabetes distress . Secondary outcomes were , among others , health status , and glycemic control ( HbA1c ) . RESULTS Compared to TAU , MBCT showed sustained reductions at follow-up in perceived stress ( p<.001 , d=.76 ) , anxiety ( p<.001 , assessed by HADS d=.83 ; assessed by POMS d=.92 ) , and HADS depressive symptoms ( p=.004 , d=.51 ) , but not POMS depressive symptoms when using Bonferroni correction for multiple testing ( p=.016 , d=.48 ) . No significant between-group effect was found on diabetes distress and HbA1c . CONCLUSION This study showed sustained benefits of MBCT six months after the intervention on emotional distress in people with diabetes and a lowered level of emotional well-being . TRIAL REGISTRATION Dutch Trial Register NTR2145 , http://www.trialregister.nl BACKGROUND Considerable research has established that self-efficacy is a consistent correlate of physical activity . Additional factors , such as exercise-induced affect , social support , and value judgments , have also 
    Output:
    
Mindfulness-based intervention  effectiveness for physiological outcomes ( glycaemic control and blood pressure ) was mixed .
Mindfulness-based interventions appear to have psychological benefits reducing depression , anxiety and distress symptoms across several studies .