***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 Evidence from the USA suggests that the home-based Family Nurse Partnership program ( FNP ) , extending from early pregnancy until infants are 24 months , can reduce the risk of child abuse and neglect throughout childhood . FNP is now widely available in the UK . A new variant , Group Family Nurse Partnership ( gFNP ) offers similar content but in a group context and for a shorter time , until infants are 12 months old . Each group comprises 8 to 12 women with similar expected delivery date s and their partners . Its implementation has been established but there is no evidence of its effectiveness . Methods / Design The study comprises a multi-site r and omized controlled trial design ed to identify the benefits of gFNP compared to st and ard care .  Participants ( not eligible for FNP ) must be either aged < 20 years at their last menstrual period ( LMP ) with one or more previous live births , or aged 20 to 24 at LMP with low educational qualifications and no previous live births . ‘ Low educational qualifications ’ is defined as not having both Maths and English Language GCSE at grade C or higher or , if they have both , no more than four in total at grade C or higher . Exclusions are : under 20 years and previously received home-based FNP and , in either age group , severe psychotic mental illness or not able to communicate in English . Consenting women are r and omly allocated ( minimized by site and maternal age group ) when between 10 and 16 weeks pregnant to either to the 44 session gFNP program or to st and ard care after the collection of baseline information . Research ers are blind to group assignment . The primary outcomes at 12 months are child abuse potential based on the revised Adult-Adolescent Parenting Inventory and parent/infant interaction coded using the CARE Index based on a video-taped interaction . Secondary outcomes are maternal depression , parenting stress , health related quality of life , social support , and use of services . Discussion This is the first study of the effectiveness of gFNP in the UK . Results should inform decision-making about its delivery alongside universal services , potentially enabling a wider range of families to benefit from the FNP curriculum and approach to supporting parenting . Trial registration IS RCT N78814904 OBJECTIVE To study the effect of integrated yoga on  Pregnancy experience , anxiety , and depression in normal pregnancy . METHODS This Prospect i ve R and omized control study recruited 96 women in 20th week of normal pregnancy .  Yoga group ( n = 51 ) practice d integrated yoga and control group ( n = 45 ) did st and ard antenatal exercises , one hour daily , from 20th to 36th week of gestation . Mann-Whitney and Wilcoxon 's tests were used for statistical analysis . RESULTS There was significant difference between groups ( Mann-Whitney p < 0.001 ) in all variables . There were significant changes within groups ( Wilcoxon 's p < 0.001 ) in both groups . Pregnancy related experience ( PEQ ) reduced in yoga by 26.86 % , State ( STAI I ) anxiety ( decreased 15.65 % in yoga , increased 13.76 % in control ) , Trait ( STAI II ) anxiety ( decreased 8.97 % in yoga , increased 5.02 % in control ) and Depression ( HADS ) ( decreased 30.67 % in yoga , increased 3.57 % in control ) . CONCLUSION Yoga reduces anxiety , depression and pregnancy related uncomfortable experiences BACKGROUND Yoga may be well suited for depressed and anxious pregnant women , given reported benefits of meditation and physical activity and pregnant women 's preference for nonpharmacological treatments . METHODS We r and omly assigned 46 pregnant women with symptoms of depression and anxiety to an 8-week yoga intervention or treatment-as-usual ( TAU ) in order to examine feasibility and preliminary outcomes . RESULTS Yoga was associated with high levels of credibility and satisfaction as an intervention for depression and anxiety during pregnancy . Participants in both conditions reported significant improvement in symptoms of depression and anxiety over time ; and yoga was associated with significantly greater reduction in negative affect as compared to TAU ( β = -0.53 , SE = 0.20 , p = .011 ) . CONCLUSION Prenatal yoga was found to be a feasible and acceptable intervention and was associated with reductions in symptoms of anxiety and depression ; however , prenatal yoga only significantly outperformed TAU on reduction of negative affect BACKGROUND Postnatal and antenatal depression are a focus of considerable clinical and research attention , but little is known about the patterns of anxiety across this period . METHODS  Self-reported anxiety and depression were assessed at 18 and 32 weeks gestation and 8 weeks and 8 months postnatally in a prospect i ve longitudinal study of a community sample of women in Engl and ( n=8323 ) . RESULTS The majority of cases of postnatal depression were preceded by antenatal depression ; similarly , postnatal anxiety was preceded by antenatal anxiety . Despite the stability of anxiety and depression across this period , there was a mean decrease in both anxiety and depression . Finally , antenatal anxiety predicted postnatal depression at 8 weeks and 8 months , even after controlling for antenatal depression ( OR=3.22 , p<0.001 ) . LIMITATIONS Data were based on self-report only and there was evidence of selective attrition . CONCLUSION The findings confirm that antenatal anxiety occurs frequently , overlaps with depression and increases the likelihood of postnatal depression Summary Stress and negative mood during pregnancy increase risk for poor childbirth outcomes and postnatal mood problems and may interfere with mother – infant attachment and child development . However , relatively little research has focused on the efficacy of psychosocial interventions to reduce stress and negative mood during pregnancy . In this study , we developed and pilot tested an eight-week mindfulness-based intervention directed toward reducing stress and improving mood in pregnancy and early postpartum . We then conducted a small r and omized trial ( n = 31 ) comparing women who received the intervention during the last half of their pregnancy to a wait-list control group .  Measures of perceived stress , positive and negative affect , depressed and anxious mood , and affect regulation were collected prior to , immediately following , and three months after the intervention ( postpartum ) . Mothers who received the intervention showed significantly reduced anxiety ( effect size , 0.89 ; p < 0.05 ) and negative affect ( effect size , 0.83 ; p < 0.05 ) during the third trimester in comparison to those who did not receive the intervention . The brief and nonpharmaceutical nature of this intervention makes it a promising c and i date for use during pregnancy Background Poor recruitment and retention of participants in r and omised controlled trials ( RCTs ) is problematic but common . Clear and detailed reporting of participant flow is essential to assess the generalisability and comparability of RCTs . Despite improved reporting since the implementation of the CONSORT statement , important problems remain . This paper aims : ( i ) to up date and extend previous review s evaluating reporting of participant recruitment and retention in RCTs ; ( ii ) to quantify the level of participation throughout RCTs . Methods We review ed all reports of RCTs of health care interventions and /or processes with individual r and omisation , published July – December 2004 in six major journals . Short , secondary or interim reports , and Phase I/II trials were excluded . Data recorded were : general RCT details ; inclusion of flow diagram ; participant flow throughout trial ; reasons for non-participation/withdrawal ; target sample sizes . Results 133 reports were review ed . Overall , 79 % included a flow diagram , but over a third were incomplete . The majority reported the flow of participants at each stage of the trial after r and omisation . However , 40 % failed to report the numbers assessed for eligibility . Percentages of participants retained at each stage were high : for example , 90 % of eligible individuals were r and omised , and 93 % of those r and omised were outcome assessed . On average , trials met their sample size targets . However , there were some substantial shortfalls : for example 21 % of trials reporting a sample size calculation failed to achieve adequate numbers at r and omisation , and 48 % at outcome assessment . Reporting of losses to follow up was variable and difficult to interpret . Conclusion The majority of RCTs reported the flow of participants well after r and omisation , although only two-thirds included a complete flow chart and there was great variability over the definition of " lost to follow up " . Reporting of participant eligibility was poor , making assessment s of recruitment practice and external validity difficult . Reporting of participant flow throughout RCTs could be improved by small changes to the CONSORT chart This r and omised controlled pilot trial tested a six-week mindfulness-based intervention in a sample of pregnant women experiencing high levels of perceived stress and pregnancy anxiety . Forty-seven women enrolled between 10 and 25 weeks gestation were r and omly assigned to either a series of weekly Mindful Awareness Practice s classes ( n = 24 ) with home practice or to a reading control condition ( n = 23 ) . Hierarchical linear models of between-group differences in change over time demonstrated that participants in the mindfulness intervention experienced larger decreases from pre-to post-intervention in pregnancy-specific anxiety and pregnancy-related anxiety ( PRA ) than participants in the reading control condition . However , these effects were not sustained through follow-up at six weeks post-intervention . Participants in both groups experienced increased mindfulness , as well as decreased perceived stress and state anxiety over the course of the intervention and follow-up periods . This study is one of the first r and omised controlled pilot trials of a mindfulness meditation intervention during pregnancy and provides some evidence that mindfulness training during pregnancy may effectively reduce PRA and worry . We discuss some of the dilemmas in pursuing this translational strategy and offer suggestions for research ers interested in conducting mind-body interventions during pregnancy Background National guidelines in the UK , United States of America , Canada , and Australia have recently stressed the importance of identifying and treating antenatal anxiety and depression . However , there is little research into the most effective and acceptable ways of helping women manage their symptoms of anxiety and stress during pregnancy . Research indicates the necessity to consider the unique needs and concerns of perinatal population s to ensure treatment engagement , highlighting the need to develop specialised treatments which could be integrated within routine antenatal healthcare services . This trial aims to develop a brief intervention for antenatal anxiety , with a focus on embedding the delivery of the treatment within routine antenatal care . Methods / Design This study is a two-phase feasibility trial . In phase 1 we will develop and pilot a brief intervention for antenatal anxiety , blended with group support , to be led by midwives . This intervention will draw on cognitive behavioural principles and wider learning from existing interventions that have been used to reduce anxiety in expectant mothers . The intervention will then be tested in a pilot r and omised controlled trial in phase 2 . The following outcomes will be assessed : ( 1 ) number of participants meeting eligibility criteria  , ( 2 ) number of participants consenting to the study , ( 3 )  number of participants r and omised  , ( 4 ) number of sessions completed by those in the intervention arm , and ( 5 ) number of participants completing the post-intervention outcome measures . Secondary outcomes comprise : detailed feedback on acceptability , which will guide further development of the intervention ; and outcome data on symptoms of maternal and paternal anxiety and depression , maternal quality of life , quality of couple relationship , mother-child bonding , infant temperament and infant sleep . Discussion The study will provide important data to inform the design of a future full-scale r and omised controlled trial of a brief intervention for anxiety during pregnancy . This will include information on its acceptability and feasibility regarding implementation within current antenatal services , which will inform whether ultimately this provision could be rolled out widely in healthcare setting s . Trial registration Current Controlled Trials IS RCT N95282830 . Registered on 29 October 2014 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 Background Mindfulness interventions to reduce psychological distress are well-suited to pregnancy , due to their brief and non-pharmacological nature , but there is a need for more robust evidence determining their usefulness . This pilot study was design ed to explore the feasibility of a r and omised controlled trial of a mindfulness intervention to reduce antenatal depression , anxiety and stress . Methods The study was design ed in two parts 1 ) a non-r and omised trial targeting women at risk of mental health problems ( a selected population ) and 2 ) a r and omised controlled trial ( RCT ) of a universal population . Process evaluation focused on feasibility of recruitment pathways , participant retention , acceptability of study measures , and engagement with mindfulness practice s. Measurement of psychological distress was taken pre and post intervention through the Centre for Epidemiologic Studies Depression Scale Revised , the Depression Anxiety and Stress Scale-21 , the State-Trait Anxiety Inventory , and the Perceived Stress Scale . Results 20 women were recruited to the non-r and omised trial , and 32 to the RCT . Recruitment through a mailed study brochure at the time of booking-in to the hospital result ed in the largest number of participants in the RCT ( 16/32 ; 50 % ) , and result ed in considerably earlier recruitment ( 50 % in first trimester , 50 % second trimester ) compared to recruitment through the antenatal clinic waiting room ( 86 % in second trimester , 14 % third trimester ) . Over a third of women in the universal population scored above clinical cut-offs for depression and anxiety , indicating a sample with more symptom 
    Output:
    
The State-Trait Anxiety Inventory was the most commonly used anxiety measure .