***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 There is an important gap between the implication s of clinical research evidence and the routine clinical practice of healthcare professionals . Because individual decisions are often central to adoption of a clinical -related behaviour , more information about the cognitive mechanisms underlying behaviours is needed to improve behaviour change interventions targeting healthcare professionals . The aim of this study was to systematic ally review the published scientific literature about factors influencing health professionals ' behaviours based on social cognitive theories . These theories refer to theories where individual cognitions/thoughts are viewed as processes intervening between observable stimuli and responses in real world situations . Methods We search ed psycINFO , MEDLINE , EMBASE , CIHNAL , Index to theses , PROQUEST dissertations and theses and Current Contents for articles published in English only . We included studies that aim ed to predict healthcare professionals ' intentions and behaviours with a clear specification of relying on a social cognitive theory . Information on percent of explained variance ( R2 ) was used to compute the overall frequency-weighted mean R2 to evaluate the efficacy of prediction in several context s and according to different method ological aspects . The cognitive factors most consistently associated with prediction of healthcare professionals ' intention and behaviours were documented . Results Seventy eight studies met the inclusion criteria . Among these studies , 72 provided information on the determinants of intention and 16 prospect i ve studies provided information on the determinants of behaviour . The theory most often used as reference was the Theory of Reasoned Action ( TRA ) or its extension the Theory of Planned Behaviour ( TPB ) . An overall frequency-weighted mean R2 of 0.31 was observed for the prediction of behaviour ; 0.59 for the prediction of intention . A number of moderators influenced the efficacy of prediction ; frequency-weighted mean R2 varied from 0.001 to 0.58 for behaviour and 0.19 to 0.81 for intention . Conclusion Our results suggest that the TPB appears to be an appropriate theory to predict behaviour whereas other theories better capture the dynamic underlying intention . In addition , given the variations in efficacy of prediction , special care should be given to method ological issues , especially to better define the context of behaviour performance Exercise capacity and quality of life ( QOL ) are important outcome predictors in patients with systolic heart failure ( HF ) , independent of left ventricular ( LV ) ejection fraction ( LVEF ) . LV diastolic function has been shown to be a better predictor of aerobic exercise capacity in patients with systolic dysfunction and a New York Heart Association ( NYHA ) classification ≥II . We hypothesized that the currently used index of diastolic function E/e ' is associated with exercise capacity and QOL , even in optimally treated HF patients with reduced LVEF . This prospect i ve study included 44 consecutive patients aged 55±11 years ( 27 men and 17 women ) , with LVEF<0.50 and NYHA functional class I-III , receiving optimal pharmacological treatment and in a stable clinical condition , as shown by the absence of dyspnea exacerbation for at least 3 months . All patients had conventional transthoracic echocardiography and answered the Minnesota Living with HF Question naire , followed by the 6-min walk test ( 6MWT ) . In a multivariable model with 6MWT as the dependent variable , age and E/e ' explained 27 % of the walked distance in 6MWT ( P=0.002 ; multivariate regression analysis ) . No association was found between walk distance and LVEF or mitral annulus systolic velocity . Only normalized left atrium volume , a sensitive index of diastolic function , was associated with decreased QOL . Despite the small number of patients included , this study offers evidence that diastolic function is associated with physical capacity and QOL and should be considered along with ejection fraction in patients with compensated systolic HF BACKGROUND Self-rated health has elicited special interest , in the wake of a number of studies demonstrating that it is a powerful predictor of future mortality , mare so for men than for women . The association between self-rated health and biological correlates also appears to differ between men and women , for reasons unknown . OBJECTIVE The purpose of this study was to examine gender differences in the interpretation and /or valuation of health-related information by comparing men and women 's association of abroad array of perceived health determinants with their statements about health . METHODS We conducted a cross-sectional study in a r and omly selected population of 8200 men and women aged > 17 years in Stockholm , Sweden . Subjects received a 120-item question naire that included measures of health care utilization , lifestyle , demographics , psychosocial factors , and mental , functional , and physical health . RESULTS Among the 5470 people who responded to the question naire , most of the 42 potential correlates ( 41 for men , 40 for women ) were significantly correlated to self-rated health . The overall association pattern was surprisingly similar for men and women . However , some small differences appeared : educational level , physical activity , and cultural activities played a more crucial role when men judged their health , whereas satisfaction with sleep and doctor visits played a more crucial role when women judged their health . These results were also for the most part confirmed in regression analyses that included all variables . The correlates explained 50 % of the variance in self-rated health for both men and women . CONCLUSIONS Our results highlight the necessity of taking a broad perspective on potential correlates when analyzing mechanisms of self-rated health . When judging their own health , men and women appear to consider approximately the same broad array of factors . The similarities in association patterns indicate that men and women interpret and /or value health-related factors similarly when making statements about health . These results may influence the medical profession 's acceptance or consideration of self-rated health . Underst and ing the gender-specific mechanisms involved in the assessment of self-rated health may contribute to the promotion of health-protective behavior and health intervention practice Depression is common in patients with heart failure ( HF ) , prognostic for adverse outcomes and purportedly related to disease severity . Psychological and physiologic factors relevant to HF were assessed in HF-ACTION , a large r and omized study of aerobic exercise training in patients with systolic HF . The relation of objective and subjective parameters was compared with scores on the Beck Depression Inventory ( BDI ) to examine the hypothesis that depressive symptoms are better associated with perception of disease severity than with objective markers of HF severity . At baseline , 2,322 of 2,331 subjects entered into HF-ACTION completed question naires to assess depression  ( BDI ) and  quality of life  ( Kansas City Cardiomyopathy Question naire [ KCCQ ] ) . Objective markers of HF severity included ejection fraction , B-type natriuretic peptide , and peak oxygen consumption ( using cardiopulmonary exercise testing , with evaluation of duration and respiratory exchange ratio also performed ) . Measures more likely to be affected by perceived functional status included New York Heart Association ( NYHA ) classification and the 6-minute walk test . Objective assessment s of disease severity were slightly related ( peak oxygen consumption ) or not related ( B-type natriuretic peptide and ejection fraction ) to BDI scores . Using multivariate analysis ( KCCQ not included ) , only age , gender , cardiopulmonary exercise testing duration , NYHA class , 6-minute walk distance , and peak respiratory exchange ratio independently correlated with BDI scores . In conclusion , depression was minimally related to objective assessment s of severity of disease in patients with HF , but was associated with patient ( and clinician ) perceptions of disease severity . Addressing depression might improve symptoms in patients with HF 
    Output:
    
Within the above-mentioned categories the presence of depressive symptoms was most consistently related to a worse HRQoL , followed by a higher New York Heart Association functional class , younger age and female gender .
Conclusion Through a systematic literature search , factors associated with HRQoL among congestive heart failure patients were investigated .
Age , gender , New York Heart Association functional class and depressive symptoms are the most consistent variables explaining the variance in HRQoL in patients with congestive heart failure .
These findings are partly in line with previous research on predictors for hard endpoints in patients with congestive heart failure