***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 AND OBJECTIVE To develop a checklist of items measuring the quality of reports of r and omized clinical trials ( RCTs ) assessing nonpharmacological treatments ( NPTs ) . STUDY DESIGN AND SETTING The Delphi consensus method was used to select and reduce the number of items in the checklist . A total of 154 individuals were invited to participate : epidemiologists and statisticians involved in the field of methodology of RCTs ( n = 55 ) , members of the Cochrane Collaboration ( n = 41 ) , and clinicians involved in planning NPT clinical trials ( n = 58 ) . Participants ranked on a 10-point Likert scale whether an item should be included in the checklist . RESULTS Fifty-five experts ( 36 % ) participated in the survey . They were experienced in systematic review s ( 68 % were involved in the Cochrane Collaboration ) and in planning RCTs ( 76 % ) . Three rounds of the Delphi method were conducted to achieve consensus . The final checklist contains 10 items and 5 subitems , with items related to the st and ardization of the intervention , care provider influence , and additional measures to minimize the potential bias from lack of blinding of participants , care providers , and outcome assessors . CONCLUSIONS This tool can be used to critically appraise the medical literature , design NPT studies , and assess the quality of trial reports included in systematic review 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 OBJECTIVE To evaluate the efficacy of Qigong in rehabilitation for patients with burnout . DESIGN Prospect i ve , r and omized controlled trial . SUBJECTS Eighty-two patients ( 68 women and 14 men , mean age 44.3 ( st and ard deviation 9.1 ) years ) diagnosed with burnout . METHODS Basic care was offered to both the intervention and the control group . Patients in the intervention group received basic care and , in addition , performed Qigong twice a week for 12 weeks .  Psychological variables , health-related quality of life , perceived relaxation and physical measurements were assessed at baseline and after the intervention period . RESULTS No significant difference in treatment efficacy between the groups was found by either intention-to-treat or per- protocol analyses . Both groups improved significantly over time , with reduced levels of burnout , fatigue , anxiety and depression , and increased dynamic balance and physical capacity . CONCLUSION In this study , a Qigong intervention twice a week for 12 weeks had no additional effect beyond basic care for patients with burnout Objective This study tests the hypothesis that stress reduction methods based on mindfulness meditation can positively influence the rate at which psoriasis clears in patients undergoing phototherapy or photochemotherapy treatment . Methods Thirty-seven patients with psoriasis about to undergo ultraviolet phototherapy ( UVB ) or photochemotherapy ( PUVA )  were r and omly assigned to one of two conditions : a mindfulness meditation-based stress reduction intervention guided by audiotaped instructions during light treatments , or a control condition consisting of the light treatments alone with no taped instructions .  Psoriasis status was assessed in three ways : direct inspection by unblinded clinic nurses ; direct inspection by physicians blinded to the patient 's study condition ( tape or no-tape ) ; and blinded physician evaluation of photographs of psoriasis lesions . Four sequential indicators of skin status were monitored during the study : a First Response Point , a Turning Point , a Halfway Point , and a Clearing Point . Results Cox-proportional hazards regression analysis showed that subjects in the tape groups reached the Halfway Point ( p = .013 ) and the Clearing Point ( p = .033 ) significantly more rapidly than those in the no-tape condition , for both UVB and PUVA treatments . Conclusions A brief mindfulness meditation-based stress reduction intervention delivered by audiotape during ultraviolet light therapy can increase the rate of resolution of psoriatic lesions in patients with psoriasis CONTEXT Qigong is a traditional Chinese health practice believed to have special healing and recovery power . Little scientific documentation was found on qigong and its effectiveness , and no literature was found on qigong as a treatment of substance addiction . OBJECTIVE To explore the effectiveness of qigong therapy on detoxification of heroin addicts compared to medical and nonmedical treatment . DESIGN Participants were r and omly assigned to 1 of 3 groups : qigong treatment group ( n = 34 ) , medication group ( n = 26 ) , and no-treatment control group ( n = 26 ) . PARTICIPANTS Eighty-six male heroin addicts , aged 18 to 52 years , who met the substance-dependence criteria of the Diagnostic and Statistical Manual of Mental Disorders , Third Edition Revised , with a history of heroin use from .5 to 11 years . All were residents at a m and atory drug-treatment center in the People 's Republic of China . INTERVENTION The qigong group practice d Pan Gu qigong and received qi adjustments from a qigong master daily . The medication group received the detoxification drug lofexidine-HCl by a 10-day gradual reduction method . The control group received only basic care and medications to treat severe withdrawal symptoms . MEASURES Urine morphine test , electrocardiogram , Hamilton Anxiety Scale , and a withdrawal-symptom evaluation scale were applied before and during the 10-day intervention . RESULTS Reduction of withdrawal symptoms in the qigong group occurred more rapidly than in the other groups . From day 1 , the qigong group had significantly lower mean symptom scores than did the other groups ( P < .01 ) . Both the qigong and medication groups had much lower anxiety scores than did the control group ( P<.01 ) , and the qigong group had significantly lower anxiety scores than did the medication group ( P<.01 ) . All subjects had a positive response to the urine morphine test before treatment . Fifty percent of the qigong group had negative urine tests on day 3 , compared to 23 % in the control group and 8 % in the medication group ( P < .01 ) . By day 5 of treatment , all subjects in the qigong group had negative urine tests , compared to day 9 for the medication group and day 11 for the control group . CONCLUSIONS Results suggest that qigong may be an effective alternative for heroin detoxification without side effects , though we can not completely eliminate the possibility of the placebo effect from the current study Background There is increasing recognition of mindfulness and mindfulness training as a way to decrease stress and increase psychological functioning . Purpose The aims of this study were to examine the effects of mindfulness stress reduction training on perceived stress and psychological well-being and to examine if changes in mindfulness mediate intervention effects on these outcomes . Methods Seventy women and one man with a previous cancer diagnosis ( mean age 51.8 years , st and ard deviation = 9.86 ) were r and omized into an intervention group or a wait-list control group . The intervention consisted of an 8-week mindfulness training course . Results Compared to participants in the control group , participants in the mindfulness training group had significantly decreased perceived stress and posttraumatic avoidance symptoms and increased positive states of mind . Those who participated in the intervention reported a significant increase in scores on the five-facet mindfulness question naire ( FFMQ ) when compared to controls . The increase in FFMQ score mediated the effects of the intervention on perceived stress , posttraumatic avoidance symptoms , and positive states of mind . Conclusions This study indicates that the improvements in psychological well-being result ing from mindfulness stress reduction training can potentially be explained by increased levels of mindfulness as measured with the FFMQ . The importance of these findings for future research in the field of mindfulness is discussed BACKGROUND Psychological distress contributes to the development of hypertension in young adults . This trial assessed the effects of a mind-body intervention on blood pressure ( BP ) , psychological distress , and coping in college students . METHODS This was a r and omized controlled trial ( RCT ) of 298 university students r and omly allocated to either the Transcendental Meditation ( TM ) program or wait-list control . At baseline and after 3 months , BP , psychological distress , and coping ability were assessed . A subgroup of 159 subjects at risk for hypertension was analyzed similarly . RESULTS Changes in systolic BP (SBP)/diastolic BP ( DBP ) for the overall sample were -2.0/-1.2 mm Hg for the TM group compared to + 0.4/+0.5 mm Hg for controls ( P = 0.15 , P = 0.15 , respectively ) . Changes in SBP/DBP for the hypertension risk subgroup were -5.0/-2.8 mm Hg for the TM group compared to + 1.3/+1.2 mm Hg for controls ( P = 0.014 , P = 0.028 , respectively ) . Significant improvements were found in total psychological distress , anxiety , depression , anger/hostility , and coping ( P values < 0.05 ) . Changes in psychological distress and coping correlated with changes in SBP ( P values < 0.05 ) and DBP ( P values < 0.08 ) . CONCLUSIONS This is the first RCT to demonstrate that a selected mind-body intervention , the TM program , decreased BP in association with decreased psychological distress , and increased coping in young adults at risk for hypertension . This mind-body program may reduce the risk for future development of hypertension in young adults OBJECTIVE The aim of this study was to investigate the potential of mindfulness-based stress reduction ( MBSR ) as a treatment for  chronic primary insomnia .  DESIGN A r and omized controlled trial was conducted . SETTING The study was conducted at a university health center . PATIENTS Thirty adults with primary chronic insomnia based on criteria of the Diagnostic and Statistical Manual of Mental Disorders , Text Revision , 4th Edition were r and omized 2:1 to MBSR or pharmacotherapy ( PCT ) . INTERVENTIONS Mindfulness-based stress reduction , a program of mindfulness meditation training consisting of eight weekly 2.5 hour classes and a daylong retreat , was provided , with ongoing home meditation practice expectations during three-month follow-up ; PCT , consisting of three milligrams of eszopiclone ( LUNESTA ) nightly for eight weeks , followed by three months of use as needed . A 10-minute sleep hygiene presentation was included in both interventions . MAIN OUTCOMES The Insomnia Severity Index ( ISI ) , Pittsburgh Sleep Quality Index ( PSQI ) , sleep diaries , and wrist actigraphy were collected pretreatment , posttreatment ( eight weeks ) , and at five months ( self-reports only ) . RESULTS Between baseline and eight weeks , sleep onset latency ( SOL ) measured by actigraphy decreased 8.9 minutes in the MBSR arm ( P < .05 ) . Large , significant improvements were found on the ISI , PSQI , and diary-measured total sleep time , SOL , and sleep efficiency ( P < .01 , all ) from baseline to five-month follow-up in the M 
    Output:
    
This review demonstrates some efficacy of meditative therapies in reducing anxiety symptoms , which has important clinical implication s for applying meditative techniques in treating anxiety .
However , most studies measured only improvement in anxiety symptoms , but not anxiety disorders as clinical ly diagnosed