***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 : Cancer is not merely an event with a certain end , but it is a permanent and vague situation that is determined by delayed effects due to the disease , its treatment and its related psychological issues . The aim of this study was to examine the effectiveness of the mindfulness-based stress reduction program and conscious yoga on the mental fatigue severity and life quality of women with breast cancer . Methods : This was a quasi-experimental study with a pre-test , post-test and control group . In this study , 24 patients with the diagnosis of breast cancer were selected among the patients who referred to the Division of Oncology and Radiotherapy of Imam Hossein hospital in Tehran using available sampling method , and were r and omly assigned into the experimental and control groups . All the participants completed the Fatigue Severity Scale , Global Life Quality of Cancer Patient and Specific Life Quality of Cancer Patient question naires . Data were analyzed by multivariate repeated measurement variance analysis model . Results : Findings revealed that the mindfulness-based stress reduction treatment significantly improved the overall quality of life , role , cognitive , emotion , social functions and pain and fatigue symptoms in global life quality in the experimental group . It also significantly improved the body image , future functions and therapy side effects in specific life quality of the experimental group compared to the control group . In addition , fatigue severity caused by cancer was reduced significantly . Conclusion : The results showed that the mindfulness - based stress reduction treatment can be effective in improving global and specific life quality and fatigue severity in women with breast cancer Research ers focused on patient-centered medicine are increasingly trying to identify baseline factors that predict treatment success . Because the quantity and function of lymphocyte subsets change during stress , we hypothesized that these subsets would serve as stress markers and therefore predict which breast cancer patients would benefit most from mindfulness-based stress reduction (MBSR)-facilitated stress relief . The purpose of this study was to assess whether baseline biomarker levels predicted symptom improvement following an MBSR intervention for breast cancer survivors ( MBSR[BC ] ) . This r and omized controlled trial involved 41 patients assigned to either an MBSR(BC ) intervention group or a no-treatment control group .  Biomarkers were assessed at baseline , and symptom change was assessed 6 weeks later . Biomarkers included common lymphocyte subsets in the peripheral blood as well as the ability of T cells to become activated and secrete cytokines in response to stimulation with mitogens . Spearman correlations were used to identify univariate relationships between baseline biomarkers and 6-week improvement of symptoms . Next , backward elimination regression models were used to identify the strongest predictors from the univariate analyses . Multiple baseline biomarkers were significantly positively related to 6-week symptom improvement . The regression models identified B-lymphocytes and interferon-γ as the strongest predictors of gastrointestinal improvement ( p < .01 ) , + CD4+CD8 as the strongest predictor of cognitive/psychological ( CP ) improvement ( p = .02 ) , and lymphocytes and interleukin (IL)-4 as the strongest predictors of fatigue improvement ( p < .01 ) . These results provide preliminary evidence of the potential to use baseline biomarkers as predictors to identify the patients likely to benefit from this intervention Background Fatigue is a common symptom in cancer patients that can persist beyond the curative treatment phase . Some evidence has been reported for interventions for fatigue during active treatment . However , to date , there is no systematic review on psychological interventions for fatigue after the completion of curative treatment for cancer . This is a protocol for a systematic review that aims to evaluate the effectiveness of psychological interventions for cancer-related fatigue in post-treatment cancer survivors . This systematic review protocol was registered with the International Prospect i ve Register of Systematic Review s ( PROSPERO ) data base . Methods / design We will search the Cochrane Central Register of Controlled Trials ( CENTRAL ; The Cochrane Library ) , PubMed , MEDLINE , EMBASE , CINAHL , PsycINFO , and relevant sources of grey literature . R and omised controlled trials ( RCTs ) which have evaluated psychological interventions in adult cancer patients after the completion of treatment , with fatigue as an outcome measure , will be included . Two review authors will independently extract data from the selected studies and assess the method ological quality using the Cochrane Collaboration Risk of Bias Tool . Discussion Most existing evidence on cancer-related fatigue is from those in active cancer treatment . This systematic review and meta- analysis will build upon previous evaluations of psychological interventions in people during and after cancer treatment . With the growing need for stage-specific research in cancer , this review seeks to highlight a gap in current practice and to strengthen the evidence base of r and omised controlled trials in the area . Systematic review registration PROSPERO CRD42014015219 Sleep disturbance is a very common problem for cancer patients that has largely not been addressed in the clinical intervention literature . Mindfulness meditation has demonstrated clinical benefits for a variety of patient population s in other areas of functioning . This study examined the effects of an 8-week Mindfulness-Based Stress Reduction ( MBSR ) program on the sleep quality of a heterogeneous sample of 63 cancer patients . Overall sleep disturbance was significantly reduced ( p < .001 ) and participants reported that their sleep quality had improved ( p < .001 ) . There was also a significant reduction in stress ( p < .001 ) , mood disturbance ( p = .001 ) , and fatigue ( p < .001 ) . The associations among these changes and implication s for improving quality of life of cancer patients are discussed OBJECTIVES Considerable morbidity persists among survivors of breast cancer ( BC ) including high levels of psychological stress , anxiety , depression , fear of recurrence , and physical symptoms including pain , fatigue , and sleep disturbances , and impaired quality of life . Effective interventions are needed during this difficult transitional period . METHODS We conducted a r and omized controlled trial of 84 female BC survivors ( Stages 0-III ) recruited from the H. Lee Moffitt Cancer and Research Institute . All subjects were within 18 months of treatment completion with surgery and adjuvant radiation and /or chemotherapy .  Subjects were r and omly assigned to a 6-week Mindfulness-Based Stress Reduction ( MBSR ) program design ed to self-regulate arousal to stressful circumstances or symptoms ( n=41 ) or to usual care ( n=43 ) . Outcome measures compared at 6 weeks by r and om assignment included vali date d measures of psychological status ( depression , anxiety , perceived stress , fear of recurrence , optimism , social support ) and psychological and physical subscales of quality of life ( SF-36 ) . RESULTS Compared with usual care , subjects assigned to MBSR(BC ) had significantly lower ( two-sided p<0.05 ) adjusted mean levels of depression ( 6.3 vs 9.6 ) , anxiety ( 28.3 vs 33.0 ) , and fear of recurrence ( 9.3 vs 11.6 ) at 6 weeks , along with higher energy ( 53.5 vs 49.2 ) , physical functioning ( 50.1 vs 47.0 ) , and physical role functioning ( 49.1 vs 42.8 ) . In stratified analyses , subjects more compliant with MBSR tended to experience greater improvements in measures of energy and physical functioning . CONCLUSIONS Among BC survivors within 18 months of treatment completion , a 6-week MBSR(BC ) program result ed in significant improvements in psychological status and quality of life compared with usual care Many breast cancer survivors have to deal with a variety of psychological and physiological sequelae including impaired immune responses . The primary purpose of this r and omized controlled trial was to determine the efficacy of a mindfulness‐based stress reduction ( MBSR ) intervention for mood disorders in women with breast cancer . Secondary outcomes were symptom experience , health status , coping capacity , mindfulness , posttraumatic growth , and immune status . This RTC assigned 166 women with breast cancer to one of three groups :  MBSR ( 8 weekly group sessions of MBSR ) , active controls ( self‐instructing MBSR ) and non‐MBSR . The primary outcome measure was the Hospital Anxiety and Depression Scale . Secondary outcome measures were : Memorial Symptom Assessment Scale , SF‐36 , Sense of Coherence , Five Facets of Mindfulness Question naire , and Posttraumatic Growth Index . Blood sample s were analyzed using flow cytometry for NK‐cell activity ( FANKIA ) and lymphocyte phenotyping ; concentrations of cytokines were determined in sera using commercial high sensitivity IL‐6 and IL‐8 ELISA ( enzyme‐linked immunosorbent assay ) kits . Results provide evidence for beneficial effects of MBSR on psychological and biological responses . Women in the MBSR group experienced significant improvements in depression scores , with a mean pre‐MBSR HAD‐score of 4.3 and post‐MBSR score of 3.3 ( P = 0.001 ) , and compared to non‐MBSR ( P = 0.015 ) . Significant improvements on scores for distress , symptom burden , and mental health were also observed . Furthermore , MBSR  facilitated coping capacity as well as mindfulness and posttraumatic growth . Significant benefits in immune response within the MBSR group and between groups were observed . MBSR have potential for alleviating depression , symptom experience , and for enhancing coping capacity , mindfulness and posttraumatic growth , which may improve breast cancer survivorship . MBSR also led to beneficial effect on immune function ; the clinical implication s of this finding merit further research Flaws in the design , conduct , analysis , and reporting of r and omised trials can cause the effect of an intervention to be underestimated or overestimated . The Cochrane Collaboration ’s tool for assessing risk of bias aims to make the process clearer and more To investigate the mechanism(s ) of action of mindfulness based stress reduction ( MBSR(BC ) ) including reductions in fear of recurrence and other potential mediators . Eighty-two post-treatment breast cancer survivors ( stages 0–III ) were r and omly assigned to a 6-week MBSR(BC ) program ( n = 40 ) or to usual care group ( UC ) ( n = 42 ) . Psychological and physical variables were assessed as potential mediators at baseline and at 6 weeks . MBSR(BC ) compared to UC experienced favorable changes for five potential mediators : ( 1 ) change in fear of recurrence problems mediated the effect of MBSR(BC ) on 6-week change in perceived stress ( z = 2.12 , p = 0.03 ) and state anxiety ( z = 2.03 , p = 0.04 ) ; and ( 2 ) change in physical functioning mediated the effect of MBSR(BC ) on 6-week change in perceived stress ( z = 2.27 , p = 0.02 ) and trait anxiety ( z = 1.98 , p = 0.05 ) . MBSR(BC )  reduces fear of recurrence and improves physical functioning which reduces perceived stress and anxiety . Findings support the beneficial effects of MBSR(BC ) and provide insight into the possible cognitive mechanism of action Background Among underserved , largely minority women who were breast cancer survivors , this pilot project was design ed to evaluate the quality of life outcomes of a 20 week Contemplative Self-Healing Program . Methods Women previously treated for stage I-III breast cancer were assessed before and after the 20 week program with the FACT-G , FACT-B , FACIT-Spirituality , ECOG , and the Impact of Events Scale . They participated in a 20-week intervention involving guided meditation and cognitive-affective-behavioral learning . Results With an average age of 63 , 62 % of the participants were African-American or Latino . With an average of 5.4 years since the diagnosis of breast cancer , 72 % had an ECOG performance status of 1 . 57 % were currently working . Their baseline FACT-G was 80.5 ± 15.1 , and their baseline Impact of Events Scale was 26.3 ± 18.9 . The within-patient improvement on the FACT-G was 4.6 ± 10.9 ( p = .01 ) ; in parallel the FACT-B improved by 2.8 ± 12.8 points ( p = .03 ) . The Impact of Events Scale improved by 6.6 ± 15.5 points ( p = .01 ) . There was significant within-patient improvement on both the avoidance scale ( 3.8 ± 9.2 ) and on the intrusion scale ( 2.9 ± 7.9 ) . Patients who attended more sessions and conducted more home practice had greater improvements in quality of life . Conclusion Persons receiving a 20-session contemplative self healing intervention  showed improved quality of life , with a clinical ly and statistically significant increase in the FACT-G. In addition , this population showed a significant reduction in post-traumatic stress symptoms assessed by the Impact of Events Scale . Trial registration Clinical Trials Gov NCT00278837 Abstract Psychological factors may influence survival in breast cancer patients but results of previous research are inconclusive . This prospect i ve population -based study tested whether depression predicts mortality in breast cancer patients .  Routinely collected depression screening data were merged with electronically archived provincial cancer registry data and censored data from British Columbia Vital Statistics ( extracted in December 2012 ) . Cox proportional-hazards regression analyses were conducted to predict all-cause and breast cancer-specific mortality as a function of depression after controlling for biomedical confounders . Of 1,646 patients , 1,604 had breast cancer stages I – III and 42 had stage IV breast cancer . 176 ( 11.0 % ) versus 28 ( 66.7 % ) were deceased after a median follow-up of 76 months . In patients with curable breast cancer , depression predicted all-cause ( H 
    Output:
    
Mindfulness-Based Stress Reduction seems to be a promising alternative for treatment of this disease 's symptoms