***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: PURPOSE The purpose of this r and omized trial was to evaluate the efficacy of the Mindfulness-Based Stress Reduction for Breast Cancer ( MBSR[BC ] ) program in improving psychological and physical symptoms and quality of life among breast cancer survivors ( BCSs ) who completed treatment . Outcomes were assessed immediately after 6 weeks of MBSR(BC ) training and 6 weeks later to test efficacy over an extended timeframe . PATIENTS AND METHODS A total of 322 BCSs were r and omly assigned to either a 6-week  MBSR(BC ) program ( n = 155 ) or a usual care group ( n = 167 ) . Psychological ( depression , anxiety , stress , and fear of recurrence ) and physical symptoms ( fatigue and pain ) and quality of life ( as related to health ) were assessed at baseline and at 6 and 12 weeks . Linear mixed models were used to assess MBSR(BC ) effects over time , and participant characteristics at baseline were also tested as moderators of MBSR(BC ) effects . RESULTS Results demonstrated extended improvement for the MBSR(BC ) group compared with usual care in both psychological symptoms of anxiety , fear of recurrence overall , and fear of recurrence problems and physical symptoms of fatigue severity and fatigue interference ( P < .01 ) . Overall effect sizes were largest for fear of recurrence problems ( d = 0.35 ) and fatigue severity ( d = 0.27 ) . Moderation effects showed BCSs with the highest levels of stress at baseline experienced the greatest benefit from MBSR(BC ) . CONCLUSION The MBSR(BC ) program significantly improved a broad range of symptoms among BCSs up to 6 weeks after MBSR(BC ) training , with generally small to moderate overall effect sizes In a r and omized controlled design , this study tested the efficacy of a theoretically based uncertainty management intervention delivered to older long-term breast cancer survivors . The sample included 509 recurrence-free women ( 360 Caucasian , 149 African-American women ) with a mean age of 64 years ( S.D.=8.9 years ) who were 5 - 9 years post-treated for breast cancer . Women were r and omly assigned to either the intervention or usual care control condition . The intervention was delivered during four weekly telephone sessions , in which study nurses guided cancer survivors in the use of audiotaped cognitive-behavioral strategies to manage uncertainty about recurrence , and a self-help manual design ed to help women underst and and manage long-term treatment side effects and other symptoms . Treatment outcome data on uncertainty management were gathered at pre-intervention and 10-months afterward . Repeated measures MANOVA evaluating treatment group , ethnic group , and treatment by ethnic interaction effects indicated that training in uncertainty management result ed in improvements in cognitive reframing , cancer knowledge , patient-health care provider communication , and a variety of coping skills . Results are discussed in terms of the importance of theory-based interventions for cancer survivors that target triggers of uncertainty about recurrence and in terms of ethnic differences in response to the intervention Purpose : The purpose of this sub study of a large r and omized controlled trial was to evaluate the efficacy of the Mindfulness-Based Stress Reduction ( Breast Cancer ) ( MBSR[BC ] ) program compared to usual care ( UC ) in normalizing blood levels of pro-inflammatory cytokines among breast cancer survivors ( BCS ) . Method : A total of 322 BCS were r and omized to either a 6-week MBSR(BC ) program or a UC . At baseline and 6 and 12 weeks , 10 ml of venous blood and demographic and clinical data were collected and /or up date d. Plasma cytokines ( interleukin [IL]-1β , IL-6 , IL-10 , tumor necrosis factor [ TNF ] α , transforming growth factor [ TGF ] β1 , soluble tumor necrosis factor receptor [ sTNFR ] 1 ) were assayed . Linear mixed models were used to assess cytokine levels across three time points ( baseline and 6 and 12 weeks ) by group ( MBSR[BC ] vs. UC ) . Results : Of the six measured cytokines , three were nondetectable at rates greater than 50 % ( IL-10 , IL-1β , TGF-β1 ) and , because of overall low prevalence , were not analyzed further . For the remaining cytokines ( TNFα , IL-6 , sTNFR1 ) , results showed that TNFα and IL-6 increased during the follow-up period ( between 6 and 12 weeks ) rather than during the MBSR(BC ) training period ( between baseline and 6 weeks ) , while sTNFR1 levels did not change significantly across the 12-week period . Conclusions : Study results suggest that MBSR(BC ) affects cytokine levels in BCS , mainly with increases in TNFα and IL-6 . The data further suggest that B-cell modulation may be a part of immune recovery during breast cancer management and that increases in TNFα and IL-6 may be markers for MBSR(BC)-related recovery Background : Recent literature has indicated that a significant percentage of oncology patients describe finding some benefit ( e.g. , improved personal growth , sense of meaning , and enhanced interpersonal relationships ) in the cancer experience . However , few studies have investigated the role of group-based psychosocial interventions in improving benefit finding ( BF ) , and virtually none have investigated these constructs in men . Purpose : This study examined whether a cognitive-behavioral stress management ( CBSM ) intervention improves BF and quality of life ( QoL ) in men recovering from treatment for localized prostate cancer . Methods : Participants in this study were 191 men ( M age = 65.1 ) treated with radiation or radical prostatectomy for clinical ly localized ( i.e. , Stage I or II ) prostate cancer . Participants were primarily non-Hispanic White ( 40 % ) or Hispanic ( 41 % ) , followed by Black ( 18 % ) and other ethnicity ( 1 % ) , were an average of 65.1 years old ( SD = 7.7 ) , and earned an average of $ 47,800 annually ( SD = $ 41,000 ) . Participants were r and omized to either a 10-week group-based cognitive-behavioral stress management intervention or a half-day educational seminar as a control condition . All participants provided demographic information and completed the Positive Contributions Scale-Cancer to assess BF , the Functional Assessment of Cancer Therapy to measure quality of life , and a measure of perceived stress management skills . Structural equation modeling was utilized for all analyses . Results : Results indicated that the CBSM condition led to increases in BF and QoL and that these changes were mediated by the development of stress management skills . Conclusions : Results support the use of group-based cognitive-behavioral interventions in promoting QoL and BF in this population Background There are few interventions for couples facing cancer . Purpose This study aims to investigate the utility of providing dyadic skills to these couples . Methods Woman recently diagnosed with breast or gynecological cancer and their partners were r and omly assigned to either a couple-skills intervention ( Side by Side ) or to cancer education ( Couples Control Program ) . Assessment s with self-report and behavioral observation of both partners were conducted four times over 16 months . Results Multilevel analyses of data from 72 participating couples suggest that females receiving Side by Side showed larger reductions in fear of progression , and couples reported less avoidance in dealing with the cancer , more posttraumatic growth , and better relationship skills relative to the Couples Control Program . All differences favoring Side by Side disappeared by 16 months after the diagnosis . ConclusionS hort-term changes in functioning may be improved by enhancing couples ’ dyadic skills during acute medical treatment of the disease OBJECTIVE To compare in a multicenter r and omized controlled trial the benefits in terms of anxiety regulation of a 15-session single-component group intervention ( SGI ) based on support with those of a 15-session multiple-component structured manualized group intervention ( MGI ) combining support with cognitive-behavioral and hypnosis components . METHODS Patients with nonmetastatic breast cancer were r and omly assigned at the beginning of the survivorship period to the SGI ( n = 83 ) or MGI ( n = 87 ) .  Anxiety regulation was assessed , before and after group interventions , through an anxiety regulation task design ed to assess their ability to regulate anxiety psychologically ( anxiety levels ) and physiologically ( heart rates ) . Question naires were used to assess psychological distress , everyday anxiety regulation , and fear of recurrence . Group allocation was computer generated and concealed till baseline completion . RESULTS Compared with patients in the SGI group ( n = 77 ) , patients attending the MGI group ( n = 82 ) showed significantly reduced anxiety after a self-relaxation exercise ( P = .006 ) and after exposure to anxiety triggers ( P = .013 ) and reduced heart rates at different time points throughout the task ( P = .001 to P = .047 ) . The MGI participants also reported better everyday anxiety regulation ( P = .005 ) , greater use of fear of recurrence-related coping strategies ( P = .022 ) , and greater reduction in fear of recurrence-related psychological distress ( P = .017 ) compared with the SGI group . CONCLUSIONS This study shows that an MGI combining support with cognitive-behavioral techniques and hypnosis is more effective than an SGI based only on support in improving anxiety regulation in patients with breast cancer OBJECTIVE In a pilot r and omized controlled trial , examine the feasibility and preliminary efficacy of an 8-week , mindfulness training program ( Mindfulness Based Stress Reduction ) in a sample of men on active surveillance on important psychological outcomes including prostate cancer anxiety , uncertainty intolerance and posttraumatic growth .  METHODS Men were r and omized to either  mindfulness ( n = 24 ) or an attention control arm ( n = 19 ) and completed self-reported measures of prostate cancer anxiety , uncertainty intolerance , global quality of life , mindfulness and posttraumatic growth at baseline , 8 weeks , 6 months and 12 months . RESULTS Participants in the mindfulness arm demonstrated significant decreases in prostate cancer anxiety and uncertainty intolerance , and significant increases in mindfulness , global mental health and posttraumatic growth . Participants in the control condition also demonstrated significant increases in mindfulness over time . Longitudinal increases in posttraumatic growth were significantly larger in the mindfulness arm than they were in the control arm . CONCLUSIONS While mindfulness training was found to be generally feasible and acceptable among participants who enrolled in the 8-week intervention as determined by completion rates and open-ended survey responses , the response rate between initial enrollment and the total number of men approached was lower than desired ( 47 % ) . While larger sample sizes are necessary to examine the efficacy of mindfulness training on important psychological outcomes , in this pilot study posttraumatic growth was shown to significantly increase over time for men in the treatment group . Mindfulness training has the potential to help men cope more effectively with some of the stressors and uncertainties associated with active surveillance . Copyright © 2016 John Wiley & Sons , PURPOSE / OBJECTIVES To determine whether breast cancer survivors ( BCSs ) who received an uncertainty management intervention  , compared to an attention control condition  , would have less uncertainty , better uncertainty management , fewer breast cancer-specific concerns , and more positive psychological outcomes . DESIGN A 2 × 2 r and omized block , repeated- measures design , with data collected at baseline and two other points postintervention , as well as a few days before or after either a mammogram or oncologist visit . SETTING Rural and urban clinical and community setting s. SAMPLE 313 female BCSs aged 50 or younger ; 117 African Americans and 196 Caucasians . METHODS Participants were blocked on ethnicity and r and omly assigned to intervention or control . The intervention , consisting of a scripted CD and a guide booklet , was supplemented by four scripted , 20-minute weekly training calls conducted by nurse interventionists . The control group received the four scripted , 20-minute weekly training calls . MAIN RESEARCH VARIABLES Uncertainty in illness , uncertainty management , breast cancer-specific concerns , and positive psychological outcomes . FINDINGS BCSs who received the intervention reported reductions in uncertainty and significant improvements in behavioral and cognitive coping strategies to manage uncertainty , self-efficacy , and sexual dysfunction . CONCLUSIONS The intervention was effective as delivered in managing uncertainties related to being a younger BCS . IMPLICATION S FOR NURSING The intervention can realistically be applied in practice because of its efficient and cost-effective nature requiring minimal direct caregiver involvement . The intervention allows survivors who are having a particular survival issue at any given point in time to access information , re sources , and management strategies . KNOWLEDGE TRANSLATION Material s tested in CD and guide booklet format could be translated into online format for survivors to access as issues arise during increasingly lengthy survivorship periods . Material s could be downloaded to a variety of electronic devices , fitting with the information needs and management styles of younger BCSs OBJECTIVE Among the most prevalent and distressing concerns endorsed by breast cancer survivors is fear of cancer recurrence ( FOR ) , and one of the most salient facets is the worry that a recurrence of cancer could cause one 's death . The primary goal of the present study was to test the effects of a brief , low-cost gratitude intervention on overall FOR and death-related FOR , positing pursuit of meaningful goals as a theoretically driven putative mediator . To replicate published tests of similar gratitude-eliciting interventions , positive affect ( PA ) was also considered as an outcome . METHOD Sixty-seven women with early stage breast cancer were r and omly assigned to either a 
    Output:
    
CONCLUSIONS Mind-body interventions are efficacious for reducing FCR , with small-to-medium effect sizes that persist after intervention delivery ends .