***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 Although epidemiological studies have reported protective effects of religion and spirituality on mental health , it is unknown whether spirituality can be used as an intervention to improve psychological well-being . OBJECTIVE To evaluate the efficacy of a home study -based spirituality program on mood disturbance in emotionally distressed patients . DESIGN , SETTING , AND PARTICIPANTS A non-blinded , r and omized , wait list-controlled trial of 165 individuals with mood disturbance [ score of > 40 on the Profile of Mood States ( POMS ) ] were recruited from primary care clinics in a Canadian city between August 2000 and March 2001 . INTERVENTIONS Participants were r and omized to a spirituality group ( an 8-week audiotaped spirituality home- study program ) , a mindfulness meditation-based stress reduction group ( attendance at facilitated classes for 8 weeks ) , or a wait-list control group ( no intervention for 12 weeks ) . MAIN OUTCOME MEASURES Primary outcomes were mood disturbance , measured using POMS , and quality of life , measured using the SF-36 , a short-form health survey with 36 questions . The POMS and the SF-36 were completed at baseline , at 8 weeks , and at 12 weeks . RESULTS At the end of the 8-week intervention period , the mean POMS score improvement was -43.1 ( -45.7 % ) for the spirituality group , -22.6 ( -26.3 % ) for the meditation group , and -10.3 ( 11.3 % ) for the control group ( P<.001 for spirituality vs control group ; P=.034 for spirituality vs meditation group ) . Mean improvement in the SF-36 mental component summary score was 14.4 ( 48.6 % ) for the spirituality group , 7.1 ( 22.3 % ) for the meditation group , and 4.7 ( 16.1 % ) for the control group ( P<.001 for spirituality vs control group ; P=.029 for spirituality vs meditation group ) . At 12 weeks , POMS and SF-36 scores remained significantly different from baseline for the spirituality group Background Although several studies have reported positive effects of mindfulness-based stress reduction ( MBSR ) intervention on psychological well-being , it is not known whether these effects are attributable to a change in mindfulness . Purpose The aim of this study is to compare the effects of MBSR to a waiting-list control condition in a r and omized controlled trial while examining potentially mediating effects of mindfulness . Methods Forty women and 20 men from the community with symptoms of distress ( mean age 43.6 years , SD = 10.1 ) were r and omized into a group receiving MBSR or a waiting-list control group . Before and after the intervention period , question naires were completed on psychological well-being , quality of life , and mindfulness . Results Repeated measures multiple analysis of variance ( MANCOVAs ) showed that , compared with the control group , the intervention result ed in significantly stronger reductions of perceived stress ( p = 0.016 ) and vital exhaustion ( p = 0.001 ) and stronger elevations of positive affect ( p = 0.006 ) , quality of life ( p = .009 ) , as well as mindfulness ( p = 0.001 ) . When mindfulness was included as a covariate in the MANCOVA , the group effects on perceived stress and quality of life were reduced to non significance . Conclusion Increased mindfulness may , at least partially , mediate the positive effects of mindfulness-based stress reduction intervention Objective : The underlying changes in biological processes that are associated with reported changes in mental and physical health in response to meditation have not been systematic ally explored . We performed a r and omized , controlled study on the effects on brain and immune function of a well‐known and widely used 8‐week clinical training program in mindfulness meditation applied in a work environment with healthy employees . Methods : We measured brain electrical activity before and immediately after , and then 4 months after an 8‐week training program in mindfulness meditation .  Twenty‐five subjects were tested in the meditation group . A wait‐list control group ( N = 16 ) was tested at the same points in time as the meditators . At the end of the 8‐week period , subjects in both groups were vaccinated with influenza vaccine . Results : We report for the first time significant increases in left‐sided anterior activation , a pattern previously associated with positive affect , in the meditators compared with the nonmeditators . We also found significant increases in antibody titers to influenza vaccine among subjects in the meditation compared with those in the wait‐list control group . Finally , the magnitude of increase in left‐sided activation predicted the magnitude of antibody titer rise to the vaccine . Conclusions : These findings demonstrate that a short program in mindfulness meditation produces demonstrable effects on brain and immune function . These findings suggest that meditation may change brain and immune function in positive ways and underscore the need for additional research Purpose . To determine if participation in a Wellness-Based Mindfulness Stress Reduction intervention decreases the effect of daily hassles , psychological distress , and medical symptoms . Design . A r and omized controlled trial of a stress reduction intervention with a 3-month follow-up . Setting . A university setting in West Virginia . Subjects . A total of 103 adults , with 59 in the intervention group and 44 in the control group . Eight-five percent of subjects completed the intervention . Fifty-nine percent and 61 % of the intervention and control subjects completed the study , respectively . Intervention . The intervention consisted of an 8-week group stress reduction program in which subjects learned , practice d , and applied “ mindfulness meditation ” to daily life situations . The control group received educational material s and were encouraged to use community re sources for stress management . Measures . The Daily Stress Inventory assessed the effect of daily hassles , the Revised Hopkins Symptom Checklist measured psychological distress , the Medical Symptom Checklist measured number of medical symptoms , and a Follow-up Question naire measured program adherence . Results . Intervention subjects reported significant decreases from baseline in effect of daily hassles ( 24 % ) , psychological distress , ( 44 % ) , and medical symptoms ( 46 % ) that were maintained at the 3-month follow-up compared to control subjects ( repeated measures analysis of variance [ ANOVA ] ; p < .05 ) . Conclusions . Self-selected community residents can improve their mental and physical health by participating in a stress reduction intervention offered by a university wellness program OBJECTIVES Patients with chronic obstructive lung disease ( COPD ) suffer from significant dyspnea and may benefit from complementary and alternative medicine ( CAM ) therapies aim ed at mitigating symptoms . The objective of this study was to test the efficacy of a mindfulness-based breathing therapy ( MBBT ) on improving symptoms and health-related quality of life in those with COPD . DESIGN We conducted a r and omized controlled trial of 8-week mindfulness-based breathing therapy ( MBBT ) compared to support groups to test efficacy on improving symptoms and health-related quality of life in those with COPD . SETTING The setting for this study was an academic-affiliated veterans healthcare system . SUBJECTS The subjects consisted of 86 patients with COPD . INTERVENTIONS MBBT included weekly meetings practicing mindfulness mediation and relaxation response . OUTCOME MEASURES The main outcome measure was a post 6-minute-walk test ( 6MWT ) Borg dyspnea assessment . Other outcome measures included health-related quality of life measures , 6MWT distance , symptom scores , exacerbation rates , and measures of stress and mindfulness . Analysis of covariance compared differences in outcomes between groups ; paired t test evaluated changes within groups . RESULTS Participants were predominantly elderly men with moderate to severe COPD . We found no improvements in dyspnea ( post 6MWT Borg difference between the MBBT and support group was 0.3 ( 95 % confidence interval [ CI ] : -1.1 , 1.7 ) . We found no differences between groups in almost all other outcome measures by either intention-to-treat analysis or within the subset that completed assigned group sessions . For the physical summary scale of the generic Short Form-36 for Veterans , the difference between outcomes favored the support group ( 4.3 , 95 % CI : 0.4 , 8.1 ) . Participant retention was low compared to mind-body trials that r and omize from CAM wait lists . CONCLUSIONS This trial found no measurable improvements in patients with COPD receiving a mindfulness-based breathing CAM therapy compared to a support group , suggesting that this intervention is unlikely to be an important therapeutic option for those with moderate-to-severe COPD Objective : Health-related quality of life ( HRQOL ) is often much reduced among individuals with multiple sclerosis ( MS ) , and incidences of depression , fatigue , and anxiety are high . We examined effects of a mindfulness-based intervention ( MBI ) compared to usual care ( UC ) upon HRQOL , depression , and fatigue among adults with relapsing-remitting or secondary progressive MS . Methods : A total of 150 patients were r and omly assigned to the intervention ( n = 76 ) or to UC ( n = 74 ) . MBI consisted of a structured 8-week program of mindfulness training . Assessment s were made at baseline , postintervention , and 6 months follow-up . Primary outcomes included disease-specific and disease-aspecific HRQOL , depression , and fatigue . Anxiety , personal goal attainment , and adherence to homework were secondary outcomes . Results : Attrition was low in the intervention group ( 5 % ) and attendance rate high ( 92 % ) . Employing intention-to-treat analysis , MBI , compared with UC , improved nonphysical dimensions of primary outcomes at postintervention and follow-up ( p < 0.002 ) ; effect sizes , 0.4–0.9 posttreatment and 0.3–0.5 at follow-up . When analyses were repeated among subgroups with clinical ly relevant levels of preintervention depression , fatigue , or anxiety , postintervention and follow-up effects remained significant and effect sizes were larger than for the total sample . Conclusions : In addition to evidence of improved HRQOL and well-being , these findings demonstrate broad feasibility and acceptance of , as well as satisfaction and adherence with , a program of mindfulness training for patients with MS . The results may also have treatment implication s for other chronic disorders that diminish HRQOL . Classification of evidence : This trial provides Class III evidence that MBI compared with UC improved HRQOL , fatigue , and depression up to 6 months postintervention For people at risk of depressive relapse , mindfulness-based cognitive therapy ( MBCT ) has an additive benefit to usual care ( H. F. Coelho , P. H. Canter , & E. Ernst , 2007 ) . This study asked if , among patients with recurrent depression who are treated with antidepressant medication ( ADM )  , MBCT is comparable to treatment with maintenance ADM ( m-ADM ) in ( a ) depressive relapse prevention , ( b ) key secondary outcomes , and ( c ) cost effectiveness . The study design was a parallel 2-group r and omized controlled trial comparing those on m-ADM ( N = 62 ) with those receiving MBCT plus support to taper/discontinue antidepressants ( N = 61 ) . Relapse/recurrence rates over 15-month follow-ups in MBCT were 47 % , compared with 60 % in the m-ADM group ( hazard ratio = 0.63 ; 95 % confidence interval : 0.39 to 1.04 ) . MBCT was more effective than m-ADM in reducing residual depressive symptoms and psychiatric comorbidity and in improving quality of life in the physical and psychological domains . There was no difference in average annual cost between the 2 groups . Rates of ADM usage in the MBCT group was significantly reduced , and 46 patients ( 75 % ) completely discontinued their ADM . For patients treated with ADM , MBCT may provide an alternative approach for relapse prevention 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 UNLABELLED Mindfulness meditation training has stress reduction benefits in various patient population s , but its effects on biological markers of HIV-1 progression are unknown . The present study tested the efficacy of an 8-week Mindfulness-based stress reduction ( MBSR ) meditation program compared to a 1-day control seminar on CD4 + T lymphocyte counts in stressed HIV infected adults . A single-blind r and omized controlled trial was conducted with enrollment and follow-up occurring between November 2005 and December 2007 . A diverse community sample of 48 HIV-1 infected adults was r and omized and entered treatment in either an 8-week MBSR or a 1-day control stress reduction education seminar . The primary outcome was circulating counts of CD4 + T lymphocytes . Participants in the 1-day control seminar showed declines in CD4 + T lymphocyte counts whereas counts among participants in the 8-week MBSR program were 
    Output:
    
Evidence supports that  MBSR improves mental health and MBCT prevents depressive relapse .