***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 Fast-acting medications for the management of anxiety are important to patients and society . Measuring early onset , however , requires a sensitive and clinical ly responsive tool . This study evaluates the psychometric properties of a patient-reported Global Anxiety - Visual Analog Scale ( GA-VAS ) . Methods Data from a double-blind , r and omized , placebo-controlled study of lorazepam and paroxetine in patients with Generalized Anxiety Disorder were analyzed to assess the reliability , validity , responsiveness , and utility of the GA-VAS . The GA-VAS was completed at clinic visits and at home during the first week of treatment . Targeted psychometric analyses — test-retest reliabilities , validity correlations , responsiveness statistics , and minimum important differences — were conducted . Results The GA-VAS correlates well with other anxiety measures , at Week 4 , r = 0.60 ( p < 0.0001 ) with the Hamilton Rating Scale for Anxiety and r = 0.74 ( p < 0.0001 ) with the Hospital Anxiety and Depression Scale - Anxiety subscale . In terms of convergent and divergent validity , the GA-VAS correlated -0.54 ( p < 0.0001 ) , -0.48 ( p < 0.0001 ) , and -0.68 ( p < 0.0001 ) with the SF-36 Emotional Role , Social Function , and Mental Health subscales , respectively , but correlated much lower with the SF-36 physical functioning subscales . Preliminary minimum important difference estimates cluster between 10 and 15 mm . Conclusions The GA-VAS is capable of validly and effectively capturing a reduction in anxiety as quickly as 24 hours post-dose Cognitive re appraisal can foster emotion regulation , yet less is known about whether cognitive re appraisal alters neuroendocrine stress reactivity . Some initial evidence suggests that although long-term training in cognitive behavioral therapy techniques ( which include re appraisal as a primary training component ) can reduce cortisol reactivity to stress , some studies also suggest that re appraisal is associated with heightened cortisol stress reactivity . To address this mixed evidence , the present report describes two experimental studies that r and omly assigned young adult volunteers to use cognitive re appraisal while undergoing laboratory stressors . Relative to the control condition , participants in the re appraisal conditions showed greater peak cortisol reactivity in response to a socially evaluative speech task ( Experiment 1 , N=90 ) and to a physical pain cold pressor task ( Experiment 2 , N=94 ) . Participants in the cognitive re appraisal group also reported enhanced anticipatory psychological appraisal s of self-efficacy and control in Experiment 2 and greater post-stressor self-efficacy . There were no effects of the re appraisal manipulation on positive and negative subjective affect , pain , or heart rate in either experiment . These findings suggest that although cognitive re appraisal fosters psychological perceptions of self-efficacy and control under stress , this effortful emotion regulation strategy in the short-term may increase cortisol reactivity . Discussion focuses on promising psychological mechanisms for these cognitive re appraisal effects Research ers have theorized that changing the way we think about our bodily responses can improve our physiological and cognitive reactions to stressful events . However , the underlying processes through which mental states improve downstream outcomes are not well understood . To this end , we examined whether reappraising stress-induced arousal could improve cardiovascular outcomes and decrease attentional bias for emotionally negative information .  Participants were r and omly assigned to either a re appraisal condition in which they were instructed to think about their physiological arousal during a stressful task as functional and adaptive , or to 1 of 2 control conditions : attention reorientation and no instructions . Relative to controls , participants instructed to reappraise their arousal exhibited more adaptive cardiovascular stress responses-increased cardiac efficiency and lower vascular resistance- and decreased attentional bias . Thus , reappraising arousal shows physiological and cognitive benefits . Implication s for health and potential clinical applications are discussed OBJECTIVE This study sought to examine the relationship among the amount of stress , the perception that stress affects health , and health and mortality outcomes in a nationally representative sample of U.S. adults . METHODS Data from the 1998 National Health Interview Survey were linked to prospect i ve National Death Index mortality data through 2006 . Separate logistic regression models were used to examine the factors associated with current health status and psychological distress . Cox proportional hazard models were used to determine the impact of perceiving that stress affects health on all-cause mortality . Each model specifically examined the interaction between the amount of stress and the perception that stress affects health , controlling for sociodemographic , health behavior , and access to health care factors . RESULTS 33.7 % of nearly 186 million ( unweighted n = 28,753 ) U.S. adults perceived that stress affected their health a lot or to some extent . Both higher levels of reported stress and the perception that stress affects health were independently associated with an increased likelihood of worse health and mental health outcomes . The amount of stress and the perception that stress affects health interacted such that those who reported a lot of stress and that stress impacted their health a lot had a 43 % increased risk of premature death ( HR = 1.43 , 95 % CI [ 1.2 , 1.7 ] ) . CONCLUSIONS High amounts of stress and the perception that stress impacts health are each associated with poor health and mental health . Individuals who perceived that stress affects their health and reported a large amount of stress had an increased risk of premature death Prior research suggests that stress can be harmful in high-stakes context s such as negotiations . However , few studies actually measure stress physiologically during negotiations , nor do studies offer interventions to combat the potential negative effects of heightened physiological responses in negotiation context s. In the current research , we offer evidence that the negative effects of cortisol increases on negotiation performance can be reduced through a re appraisal of anxiety manipulation . We experimentally induced adaptive appraisal s by r and omly assigning 97 male and female participants to receive either instructions to appraise their anxiety as beneficial to the negotiation or no specific instructions on how to appraise the situation . We also measured participants ’ cortisol responses prior to and following the negotiation . Results revealed that cortisol increases were positively related to negotiation performance for participants who were told to view anxiety as beneficial , and not detrimental , for negotiation performance ( appraisal condition ) . In contrast , cortisol increases were negatively related to negotiation performance for participants given no instructions on appraising their anxiety ( control condition ) . These findings offer a means through which to combat the potentially deleterious effects of heightened cortisol reactivity on negotiation outcomes Background The consequences of stress are typically regarded from a deficit-oriented approach , conceptualizing stress to be entirely negative in its outcomes . This approach is unbalanced , and may further hinder individuals from engaging in adaptive coping . In the current study , we explored whether negative views and beliefs regarding stress interacted with a stress framing manipulation ( positive , neutral and negative ) on measures of stress reactivity for both psychosocial and physiological stressors . Method Ninety participants were r and omized into one of three framing conditions that conceptualized the experience of stress in balanced , unbalanced-negative or unbalanced-positive ways . After watching a video on stress , participants underwent a psychosocial ( Trier Social Stress Test ) , or a physiological ( CO2 challenge ) method of stress-induction .  Subjective and objective markers of stress were assessed . Results Most of the sample d population regarded stress as negative prior to framing . Further , subjective and objective reactivity were greater to the TSST compared to the CO2 challenge . Additionally , significant cubic trends were observed in the interactions of stress framing and stress-induction method ologies on heart rate and blood pressure . Balanced framing conditions in the TSST group had a significantly larger decrease in heart rate and diastolic blood pressure following stress compared to the positive and negative framing conditions . Conclusion Findings confirmed a deficit-orientation of stress within the sample d population . In addition , results highlighted the relative efficacy of the TSST compared to CO2 as a method of stress provocation . Finally , individuals in framing conditions that posited stress outcomes in unbalanced manners responded to stressors less efficiently . This suggests that unbalanced framing of stress may have set forth unrealistic expectations regarding stress that later hindered individuals from adaptive responses to stress . Potential benefits of alternative conceptualizations of stress on stress reactivity are discussed , and suggestions for future research are made OBJECTIVES Verbally administered numerical rating scales ( NRSs ) from 0 to 10 are often used to measure pain , but they have not been vali date d in the emergency department ( ED ) setting . The authors wished to assess the comparability of the NRS and  visual analog scale ( VAS )  as measures of acute pain , and to identify the minimum clinical ly significant difference in pain that could be detected on the NRS . METHODS This was a prospect i ve cohort study of a convenience sample of adults presenting with acute pain to an urban ED . Patients  verbally rated pain intensity as an integer from 0 to 10 ( 0 = no pain , 10 = worst possible pain ) , and marked a 10-cm horizontal VAS bounded by these descriptors .  VAS and NRS data were obtained at presentation , 30 minutes later , and 60 minutes later . At 30 and 60 minutes , patients were asked whether their pain was " much less , " " a little less , " " about the same , " " a little more , " or " much more . " Differences between consecutive pairs of measurements on the VAS and NRS obtained at 30-minute intervals were calculated for each of the five categories of pain descriptor . The association between VAS and NRS scores was expressed as a correlation coefficient . The VAS scores were regressed on the NRS scores in order to assess the equivalence of the measures . The mean changes associated with descriptors " a little less " or " a little more " were combined to define the minimum clinical ly significant difference in pain measured on the VAS and NRS . RESULTS Of 108 patients entered , 103 provided data at 30 minutes and 86 at 60 minutes . NRS scores were strongly correlated to VAS scores at all time periods ( r = 0.94 , 95 % CI = 0.93 to 0.95 ) . The slope of the regression line was 1.01 ( 95 % CI = 0.97 to 1.06 ) and the y-intercept was -0.34 ( 95 % CI = -0.67 to -0.01 ) . The minimum clinical ly significant difference in pain was 1.3 ( 95 % CI = 1.0 to 1.5 ) on the NRS and 1.4 ( 95 % CI = 1.1 to 1.7 ) on the VAS . CONCLUSIONS The findings suggest that the verbally administered NRS can be substituted for the VAS in acute pain measurement ABSTRACT Background and Objectives : This study examined the effects of arousal re appraisal on cardiovascular responses , dem and and re source evaluations , self-confidence , performance and attention under pressurized conditions . A recent study by Moore et al. [ 2015 . Reappraising threat : How to optimize performance under pressure . Journal of Sport and Exercise Psychology , 37(3 ) , 339–343 . doi:10.1123/jsep.2014 - 0186 ] suggested that arousal re appraisal is beneficial to the promotion of challenge states and leads to improvements in single-trial performance . This study aim ed to further the work of Moore and colleagues ( 2015 ) by examining the effects of arousal re appraisal on cardiovascular responses , dem and and re source evaluations , self-confidence , performance and attention in a multi-trial pressurized performance situation . Design and Methods : Participants were r and omly assigned to either an arousal re appraisal intervention or control condition , and completed a pressurized dart throwing task . The intervention encouraged participants to view their physiological arousal as facilitative rather than debilitative to performance . Measures of cardiovascular reactivity , dem and and re source evaluations , self-confidence , task performance and attention were recorded . Results : The re appraisal group displayed more favorable cardiovascular reactivity and reported higher re source evaluations and higher self-confidence than the control group but no task performance or attention effects were detected . Conclusion : These findings demonstrate the strength of arousal re appraisal in promoting adaptive stress responses , perceptions of re sources and self-confidence Background and objectives : Few studies related to the impact of different emotion regulation strategies on anxiety have used externally and ecologically valid emotion-eliciting stimuli or Eastern population s. The present study compares the effects of re appraisal , suppression , and acceptance on anxiety induced by a simulated job interview in a Chinese sample . Methods : Eighty-two subjects were r and omly assigned to one of four instructions : re appraisal , suppression , acceptance , or no-regulation strategies during a simulated job interview .  Anxiety was assessed with an  observer-based behavior rating scale during the interview and the State Anxiety Inventory before , during , and after the interview . Results : A repeated- measures MANOVA indicated a significantly greater reduction in anxiety in the re appraisal and acceptance groups compared to the control group during the interview ( re appraisal : d = 1.42 ; acceptance : d = 1.30 ; each p < .001 ) , but not during the recovery stage . The suppression and control group did not differ in any stage . Suppression led to a higher ( pmax < .04 ) anxiety than re appraisal /acceptance in the anticipation ( d = 0.65/0.68 ) , interview ( d = 0.87/0.79 ) , and recovery stages ( d = 0.94/1.03 ) . No significant differences were found between re appraisal and acceptance . Conclusions : 
    Output:
    
RESULTS Findings from both the meta- analysis and systematic review revealed that overall , re appraisal interventions are effective in attenuating subjective responsivity to stress .
On one h and , findings may suggest a promising avenue for the effective management of self-reported stress and optimization of stress responses .