***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: Purpose In addition to structural transformations , deeper changes are needed to enhance physicians ’ sense of meaning and satisfaction with their work and their ability to respond creatively to a dynamically changing practice environment . The purpose of this research was to underst and what aspects of a successful continuing education program in mindful communication contributed to physicians ’ well-being and the care they provide . Method In 2008 , the authors conducted in-depth , semistructured interviews with primary care physicians who had recently completed a 52-hour mindful communication program demonstrated to reduce psychological distress and burnout  while improving empathy . Interviews with a r and om sample of 20 of the 46 physicians in the Rochester , New York , area who attended at least four of eight weekly sessions and four of eight monthly sessions were audio-recorded , transcribed , and analyzed qualitatively . The authors identified salient themes from the interviews . Results Participants reported three main themes : ( 1 ) sharing personal experiences from medical practice with colleagues reduced professional isolation , ( 2 ) mindfulness skills improved the participants ’ ability to be attentive and listen deeply to patients ’ concerns , respond to patients more effectively , and develop adaptive reserve , and ( 3 ) developing greater self-awareness was positive and transformative , yet participants struggled to give themselves permission to attend to their own personal growth . Conclusions Interventions to improve the quality of primary care practice and practitioner well-being should promote a sense of community , specific mindfulness skills , and permission and time devoted to personal growth Background Distress and burnout among medical and psychology professionals are commonly reported and have implication s for the quality of patient care delivered . Already in the course of university studies , medicine and psychology students report mental distress and low life satisfaction . There is a need for interventions that promote better coping skills in students in order to prevent distress and future burnout . This study examines the effect of a seven-week Mindfulness-Based Stress Reduction ( MBSR ) programme on mental distress , study stress , burnout , subjective well-being , and mindfulness of medical and psychology students . Methods A total of 288 students ( mean age = 23 years , 76 % female ) from the University of Oslo and the University of Tromsø were r and omly allocated to an intervention or control group . The control group continued with their st and ard university courses and received no intervention . Participants were evaluated using self-reported measures both before and after the intervention . These were : the ‘ General Health Question naire , Maslach Burnout Inventory Student version , Perceived Medical School Stress , Subjective Well-being , and Five Facet Mindfulness Question naire ’ and additional indices of compliance . Results Following the intervention , a moderate effect on mental distress ( Hedges’g 0.65 , CI = .41 , .88 ) , and a small effect on both subjective well-being ( Hedges’g 0.40 , CI = .27 , .63 ) and the mindfulness facet ‘ non-reacting ’ ( Hedges’g 0.33 , CI = .10 , .56 ) were found in the intervention group compared with the control group . A higher level of programme attendance and reported mindfulness exercises predicted these changes . Significant effects were only found for female students who additionally reported reduced study stress and an increase in the mindfulness facet ‘ non-judging ’ . Gender specific effects of participation in the MBSR programme have not previously been reported , and gender differences in the present study are discussed . Conclusion Female medical and psychology students experienced significant positive improvements in mental distress , study stress , subjective well-being and mindfulness after participating in the MBSR programme . Trial registration UNLABELLED Support staff working with individuals with intellectual disability ( ID ) and challenging behaviour experience high levels of work-related stress . Preliminary theoretical and experimental research has highlighted the potential suitability of acceptance and mindfulness approaches for addressing support staff stress . This study examines the effectiveness of an acceptance and mindfulness-based stress management workshop on the levels of psychological distress and well-being of support staff working with individuals with ID and challenging behaviour . Support staff ( n=120 ) were r and omly assigned to a  workshop intervention condition ( n=66 ) or to a waiting list control condition  ( n=54 ) . Measurements were completed at three time points ( pre- , post and 6 week follow-up ) for : psychological distress , well-being , perceived work stressors , thought suppression , and emotional avoidance/psychological inflexibility . MAIN FINDINGS The intervention led to significantly greater reductions in distress in the intervention group than in the control group . This was largely maintained at 6 week follow-up . This effect was more pronounced amongst a sub sample that had shown higher levels of psychological distress at baseline . Thought suppression was found to reduce significantly in the intervention group between post intervention and follow-up , although no significant change was found in well-being or experiential avoidance/psychological inflexibility . Overall , results demonstrated support for the effectiveness of an acceptance and mindfulness-based intervention in reducing distress This pilot aims to better underst and the market for childcare in Saudi Arabia – both the supply and dem and sides – and to design a r and omized controlled experiment to test whether access to affordable day care ( in the form of subsidies , for example ) would incentivize Saudi mothers to search actively for employment and to remain employed once they are hired . In addition , the study seeks to underst and the degree to which employment early on in one ’s life impacts employment in later stages . The pilot will provide information on the groups of women the experiment should target , appropriate levels for the childcare subsidy , and the quality and current geographic locations of daycare sites . Expected Impact Determine the effects of facilitating childcare access on Saudi women ’s employment . PRINCIPAL INVESTIGATORS  Boston University Patricia Cortes  Harvard University Claudia Goldin  Swarthmore College Jennifer The inability to cope successfully with the enormous stress of medical education may lead to a cascade of consequences at both a personal and professional level . The present study examined the short-term effects of an 8-week meditation-based stress reduction intervention on premedical and medical students using a well-controlled statistical design . Findings indicate that participation in the intervention can effectively ( 1 ) reduce self-reported state and trait anxiety , ( 2 ) reduce reports of overall psychological distress including depression , ( 3 ) increase scores on overall empathy levels , and ( 4 ) increase scores on a measure of spiritual experiences assessed at termination of intervention . These results ( 5 ) replicated in the wait-list control group , ( 6 ) held across different experiments , and ( 7 ) were observed during the exam period . Future research should address potential long-term effects of mindfulness training for medical and premedical students Part III of the study on mindfulness-based stress reduction ( MBSR ) describes qualitative data and discusses the implication s of the findings . Study analysis revealed that nurses found MBSR helpful . Greater relaxation and self-care and improvement in work and family relationships were among reported benefits . Challenges included restlessness , physical pain , and dealing with difficult emotions A pragmatic mindfulness intervention to benefit personnel working in chronically high-stress environments , delivered onsite during the workday , is timely and valuable to employee and employer alike . Mindfulness in Motion ( MIM ) is a Mindfulness Based Intervention ( MBI ) offered as a modified , less time intensive method ( compared to Mindfulness-Based Stress Reduction ) , delivered onsite , during work , and intends to enable busy working adults to experience the benefits of mindfulness . It teaches mindful awareness principles , rehearses mindfulness as a group , emphasizes the use of gentle yoga stretches , and utilizes relaxing music in the background of both the group sessions and individual mindfulness practice . MIM is delivered in a group format , for 1 hr/week/8 weeks . CDs and a DVD are provided to facilitate individual practice . The yoga movement is emphasized in the protocol to facilitate a quieting of the mind . The music is included for participants to associate the relaxed state experienced in the group session with their individual practice . To determine the intervention feasibility/efficacy we conducted a r and omized wait-list control group in Intensive Care Units ( ICUs ) . ICUs represent a high-stress work environment where personnel experience chronic exposure to catastrophic situations as they care for seriously injured/ill patients . Despite high levels of work-related stress , few interventions have been developed and delivered onsite for such environments . The intervention is delivered on site in the ICU , during work hours , with participants receiving time release to attend sessions . The intervention is well received with 97 % retention rate . Work engagement and resiliency increase significantly in the intervention group , compared to the wait-list control group , while participant respiration rates decrease significantly pre-post in 6/8 of the weekly sessions . Participants value institutional support , relaxing music , and the instructor as pivotal to program success . This provides evidence that MIM is feasible , well accepted , and can be effectively implemented in a chronically high-stress work environment CONTEXT Primary care physicians report high levels of distress , which is linked to burnout , attrition , and poorer quality of care . Programs to reduce burnout before it results in impairment are rare ; data on these programs are scarce . OBJECTIVE To determine whether an intensive educational program in mindfulness , communication , and self-awareness is associated with improvement in primary care physicians ' well-being , psychological distress , burnout , and capacity for relating to patients . DESIGN , SETTING , AND PARTICIPANTS Before- and -after study of 70 primary care physicians in Rochester , New York , in a continuing medical education ( CME ) course in 2007 - 2008 . The course included mindfulness meditation , self-awareness exercises , narratives about meaningful clinical experiences , appreciative interviews , didactic material , and discussion . An 8-week intensive phase ( 2.5 h/wk , 7-hour retreat ) was followed by a 10-month maintenance phase ( 2.5 h/mo ) . MAIN OUTCOME MEASURES Mindfulness ( 2 subscales ) , burnout ( 3 subscales ) , empathy ( 3 subscales ) , psychosocial orientation , personality ( 5 factors ) , and mood ( 6 subscales ) measured at baseline and at 2 , 12 , and 15 months . RESULTS Over the course of the program and follow-up , participants demonstrated improvements in mindfulness ( raw score , 45.2 to 54.1 ; raw score change [ Delta ] , 8.9 ; 95 % confidence interval [ CI ] , 7.0 to 10.8 ) ; burnout ( emotional exhaustion , 26.8 to 20.0 ; Delta = -6.8 ; 95 % CI , -4.8 to -8.8 ; depersonalization , 8.4 to 5.9 ; Delta = -2.5 ; 95 % CI , -1.4 to -3.6 ; and personal accomplishment , 40.2 to 42.6 ; Delta = 2.4 ; 95 % CI , 1.2 to 3.6 ) ; empathy ( 116.6 to 121.2 ; Delta = 4.6 ; 95 % CI , 2.2 to 7.0 ) ; physician belief scale ( 76.7 to 72.6 ; Delta = -4.1 ; 95 % CI , -1.8 to -6.4 ) ; total mood disturbance ( 33.2 to 16.1 ; Delta = -17.1 ; 95 % CI , -11 to -23.2 ) , and personality ( conscientiousness , 6.5 to 6.8 ; Delta = 0.3 ; 95 % CI , 0.1 to 5 and emotional stability , 6.1 to 6.6 ; Delta = 0.5 ; 95 % CI , 0.3 to 0.7 ) . Improvements in mindfulness were correlated with improvements in total mood disturbance ( r = -0.39 , P < .001 ) , perspective taking subscale of physician empathy ( r = 0.31 , P < .001 ) , burnout ( emotional exhaustion and personal accomplishment subscales , r = -0.32 and 0.33 , respectively ; P < .001 ) , and personality factors ( conscientiousness and emotional stability , r = 0.29 and 0.25 , respectively ; P < .001 ) . CONCLUSIONS Participation in a mindful communication program was associated with short-term and sustained improvements in well-being and attitudes associated with patient-centered care . Because before- and -after design s limit inferences about intervention effects , these findings warrant r and omized trials involving a variety of practicing physicians Background Nurses are an indispensable component of the work force in the health care system . However , many of them are known to work in a stressful environment which may affect their mental well-being ; the situation could be worse in rapidly transforming societies such as China . The purpose of this study was to investigate anxiety symptoms and the associated factors in Chinese nurses working in public city hospitals . Methods A cross-sectional survey was performed for Chinese nurses in public city hospitals of Liaoning Province , northeast China . Seven hospitals in different areas of the province were r and omly selected for the study . The  Zung Self-Rating Anxiety Scale  was used to measure anxiety symptoms . Effort-reward imbalance question naire and Job Content Question naire were used to assess the work stressors . Univariate analysis and stepwise multivariate logistic regression analysis were used to identify the factors associated with anxiety symptoms . Results All registered nurses in the seven city hospitals , totaling 1807 registered nurses were surveyed . Of the returned question naires , 1437 were valid ( 79.5 % ) for analysis . Utilizing the total raw score ≥ 40 as the cut-off point , the prevalence of anxiety symptoms in these nurses was 43.4 % . Demographic factors ( education , chronic disease and life event ) , lifestyle factors ( regular meals and physical exercise ) , work 
    Output:
    
RESULTS Mindfulness was generally associated with positive outcomes in relation to most measures ( although results were more equivocal with respect to some outcomes , most notably burnout ) .
Overall , mindfulness does appear to improve the well-being  of healthcare professionals .