***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 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 There is often wide variability in the reported effects of complex behavioral interventions . Effectiveness can vary across studies , sites , and providers . A factor that has been insufficiently considered is the fidelity of the behavioral treatment that was provided . Low quality practice could be likened to partial doses of a vaccine or antibiotic : the right idea but insufficient strength . Using  motivational interviewing ( MI ) as an example , the authors describe three quality conditions that should be present for a study to be regarded as a trial of a complex behavioral intervention : ( 1 ) The treatment should clearly contain the components that are theoretically or empirically related to its efficacy ; ( 2 ) providers should be trained to an adequate and specified criterion of proficiency before treating trial patients ; and ( 3 ) the fidelity of treatment should be documented by reliable coding of practice throughout the study and reported in a manner that permits comparison with skill levels in other trials . The authors also discuss bona fide intervention failures despite strong clinical trial methodology , offering recommendations for future outcome research Background : Although mindfulness meditation interventions have recently shown benefits for reducing stress in various population s , little is known about their relative efficacy compared with relaxation interventions . Purpose : This r and omized controlled trial examines the effects of a 1-month mindfulness meditation versus somatic relaxation training as compared to a control group in 83 students ( M age=25 ; 16 men and 67 women ) reporting distress . Method : Psychological distress , positive states of mind , distractive and ruminative thoughts and behaviors , and spiritual experience were measured , while controlling for social desirability . Results : Hierarchical linear modeling reveals that both meditation and relaxation groups experienced significant decreases in distress as well as increases in positive mood states over time , compared with the control group ( p<.05 in all cases ) . There were no significant differences between meditation and relaxation on distress and positive mood states over time . Effect sizes for distress were large for both meditation and relaxation ( Cohen ’s d=1.36 and .91 , respectively ) , whereas the meditation group showed a larger effect size for positive states of mind than relaxation ( Cohen ’s d=.71 and .25 , respectively ) . The meditation group also demonstrated significant pre-post decreases in both distractive and ruminative thoughts/behaviors compared with the control group ( p<.04 in all cases ; Cohen ’s d=.57 for rumination and .25 for distraction for the meditation group ) , with mediation models suggesting that mindfulness meditation ’s effects on reducing distress were partially mediated by reducing rumination . No significant effects were found for spiritual experience . Conclusions : The data suggest that compared with a no-treatment control , brief training in mindfulness meditation or somatic relaxation reduces distress and improves positive mood states . However , mindfulness meditation may be specific in its ability to reduce distractive and ruminative thoughts and behaviors , and this ability may provide a unique mechanism by which mindfulness meditation reduces distress 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 Background Determining the effectiveness of social and psychological interventions is important for improving individual and population health . Such interventions are complex and , where possible , are best evaluated by r and omised controlled trials ( RCTs ) . The use of research findings in policy and practice decision making is hindered by poor reporting of RCTs . Poor reporting limits the ability to replicate interventions , synthesis e evidence in systematic review s , and utilise findings for evidence -based policy and practice . The lack of guidance for reporting the specific method ological features of complex intervention RCTs contributes to poor reporting . We aim to develop an extension of the Consoli date d St and ards of Reporting Trials Statement for Social and Psychological Interventions ( CONSORT-SPI ) . Methods / design This research project will be conducted in five phases . The first phase was the project launch , which consisted of the establishment of a Project Executive and International Advisory Group , and recruitment of journal editors and the CONSORT Group . The second phase involves a Delphi process that will generate a list of possible items to include in the CONSORT Extension . Next , there will be a formal consensus meeting to select the reporting items to add to , or modify for , the CONSORT-SPI Extension . Fourth , guideline documents will be written , including an explanation and elaboration ( E&E ) document that will provide detailed advice for each item and examples of good reporting . The final phase will comprise guideline dissemination , with simultaneous publication and endorsement of the guideline in multiple journals , endorsement by funding agencies , presentations at conferences and other meetings , and a dedicated website that will facilitate feedback about the guideline . Conclusion As demonstrated by previous CONSORT guidelines , the development of an evidence -based reporting guideline for social and psychological intervention RCTs should improve the accuracy , comprehensiveness , and transparency of study reports . This , in turn , promises to improve the critical appraisal of research and its use in policy and practice decision making . We invite readers to participate in the project by visiting our website ( http://tinyurl.com/CONSORT- study ) 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 This article is the second in a series reporting on research exploring the effects of Mindfulness-based Stress Reduction  on nurses and describes the quantitative data . The third article describes qualitative data . Treatment  group participants reduced scores on 2 of 3 subscales of the Maslach Burnout Inventory significantly more than wait-list controls ; within-group comparisons for both groups pretreatment and posttreatment revealed similar findings . Changes were maintained as long as 3-month posttreatment . Implication s of these findings are discussed OBJECTIVES The objectives of the study were ( 1 ) to evaluate self-reported stress levels and daily spiritual experiences in academic health care employees before , immediately after , and 1 year after enrolling in a mindfulness-based stress reduction ( MBSR ) course  ; and ( 2 ) to evaluate the correlation between a potential measure of pulse rate variability and self-reported stress levels . SUBJECTS Fifty-nine ( 59 ) participants in the MBSR course offered to employees at the University of Texas Medical Branch in Galveston ( UTMB ) comprised the intervention group , and 94 health care providers in the neonatal nurseries comprised the control group . INTERVENTION MBSR is an 8-week course that introduces mindfulness meditation practice s. No intervention was offered to the control group . All participants were employees ( or relatives of employees ) at UTMB . DESIGN All MBSR participants completed Cohen 's Perceived Stress Scale , the SCL-90 , the SF-36 Measure of Health and Well-Being , the Daily Spiritual Experiences Scale , and a 5-minute measure of pulse rate coherence . This testing was done before and after the MBSR course and 1 year later . Ninety-four ( 94 ) neonatal health care providers completed the same series of question naires and pulse rate variability ( PRV ) measures , with 49 of the 94 completing the question naires 2 months and 1 year later . RESULTS MBSR participants improved on all measures except the physical component score of the SF-36 upon completion of the MBSR course , and these results were maintained at the 1-year follow-up . The control group did not significantly change on any of the measures . PRV as measured by the Heart Math system did not correlate with any of the self-report question naires . CONCLUSIONS MBSR effectively reduces self-report measures of stress and increases daily spiritual experiences in employees in an academic health care setting , and these effects are stable for at least 1 year . 
    Output:
    
Evidence regarding the effects of MBSR in professionals suggests this intervention is associated with improvements in burnout , stress , anxiety and depression .
Improvements in empathy are also suggested but no clear evidence is currently available on emotional competencies .
High quality evidence is available on the effect of MBSR on professionals ' mental health .