***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: Despite the crucial role of teachers in fostering children 's academic learning and social-emotional well-being , addressing teacher stress in the classroom remains a significant challenge in education . The present study reports results from a r and omized controlled pilot trial of a modified Mindfulness-Based Stress Reduction course ( mMBSR ) adapted specifically for teachers . Results suggest the course may be a promising intervention , with participants showing significant reductions in psychological symptoms and burnout , improvements in observer-rated classroom organization and performance on a computer task of affective attentional bias , and increases in self-compassion . In contrast , control group participants showed declines in cortisol functioning over time and marginally significant increases in burnout . Furthermore , changes in mindfulness were correlated in the expected direction with changes across several outcomes ( psychological symptoms , burnout , sustained attention ) in the intervention group . Implication s of these findings for the training and support of teachers are discussed BACKGROUND Individuals with a history of recurrent depression have a high risk of repeated depressive relapse or recurrence .  Maintenance antidepressants for at least 2 years is the current recommended treatment , but many individuals are interested in alternatives to medication . Mindfulness-based cognitive therapy ( MBCT ) has been shown to reduce risk of relapse or recurrence compared with usual care , but has not yet been compared with maintenance antidepressant treatment in a definitive trial . We aim ed to see whether MBCT with support to taper or discontinue antidepressant treatment ( MBCT-TS ) was superior to maintenance antidepressants for prevention of depressive relapse or recurrence over 24 months . METHODS In this single-blind , parallel , group r and omised controlled trial ( PREVENT ) , we recruited adult patients with three or more previous major depressive episodes and on a therapeutic dose of maintenance antidepressants , from primary care general practice s in urban and rural setting s in the UK . Participants were r and omly assigned to either MBCT-TS or maintenance antidepressants ( in a 1:1 ratio ) with a computer-generated r and om number sequence with stratification by centre and symptomatic status . Participants were aware of treatment allocation and research assessors were masked to treatment allocation . The primary outcome was time to relapse or recurrence of depression , with patients followed up at five separate intervals during the 24-month study period . The primary analysis was based on the principle of intention to treat . The trial is registered with Current Controlled Trials , IS RCT N26666654 . FINDINGS Between March 23 , 2010 , and Oct 21 , 2011 , we assessed 2188 participants for eligibility and recruited 424 patients from 95 general practice s. 212 patients were r and omly assigned to MBCT-TS and 212 to maintenance antidepressants . The time to relapse or recurrence of depression did not differ between MBCT-TS and maintenance antidepressants over 24 months ( hazard ratio 0·89 , 95 % CI 0·67 - 1·18 ; p=0·43 ) , nor did the number of serious adverse events . Five adverse events were reported , including two deaths , in each of the MBCT-TS and maintenance antidepressants groups . No adverse events were attributable to the interventions or the trial . INTERPRETATION We found no evidence that MBCT-TS is superior to maintenance antidepressant treatment for the prevention of depressive relapse in individuals at risk for depressive relapse or recurrence . Both treatments were associated with enduring positive outcomes in terms of relapse or recurrence , residual depressive symptoms , and quality of life . FUNDING National Institute for Health Research ( NIHR ) Health Technology Assessment ( HTA ) programme , and NIHR Collaboration for Leadership in Applied Health Research and Care South West Peninsula UNLABELLED RATIONALE , AIMS & OBJECTIVE : Tools for the assessment of the quality of research studies tend to be specific to a particular research design ( e.g. r and omized controlled trials , or qualitative interviews ) . This makes it difficult to assess the quality of a body of research that addresses the same or a similar research question but using different approaches . The aim of this paper is to describe the development and preliminary evaluation of a  quality assessment tool that can be applied to a method ologically diverse set of research articles . METHODS The  16-item quality assessment tool ( QATSDD )  was assessed to determine its reliability and validity when used by health services research ers in the disciplines of psychology , sociology and nursing . Qualitative feedback was also gathered from mixed- methods health research ers regarding the comprehension , content , perceived value and usability of the tool . RESULTS Reference to existing widely used quality assessment tools and experts in systematic review confirmed that the components of the tool represented the construct of ' good research technique ' being assessed . Face validity was subsequently established through feedback from a sample of nine health research ers .  Inter-rater reliability was established through substantial agreement between three review ers when applying the tool to a set of three research papers ( κ = 71.5 % ) , and good to substantial agreement between their scores at time 1 and after a 6-week interval at time 2 confirmed test-retest reliability . CONCLUSIONS The QATSDD shows good reliability and validity for use in the quality assessment of a diversity of studies , and may be an extremely useful tool for review ers to st and ardize and increase the rigour of their assessment s in review s of the published papers which include qualitative and quantitative work Positive psychology has flourished in the last 5 years . The authors review recent developments in the field , including books , meetings , courses , and conferences . They also discuss the newly created classification of character strengths and virtues , a positive complement to the various editions of the Diagnostic and Statistical Manual of Mental Disorders ( e. g. , American Psychiatric Association , 1994 ) , and present some cross-cultural findings that suggest a surprising ubiquity of strengths and virtues . Finally , the authors focus on psychological interventions that increase individual happiness . In a 6-group , r and om-assignment ,  placebo-controlled Internet study , the authors tested 5 purported happiness interventions and 1 plausible control exercise . They found that 3 of the interventions lastingly increased happiness and decreased depressive symptoms . Positive interventions can supplement traditional interventions that relieve suffering and may someday be the practical legacy of positive psychology This prospect i ve study with 464 older adolescents ( 14 to 19 years at Time 1 ; 16 to 21 years at Time 2 ) tested the structural paths of influence through which perceived self-efficacy for affect regulation  operates in concert with perceived behavioral efficacy in governing diverse spheres of psychosocial functioning . Self-efficacy to regulate positive and negative affect is accompanied by high efficacy to manage one 's academic development , to resist social pressures for antisocial activities , and to engage oneself with empathy in others ' emotional experiences . Perceived self-efficacy for affect regulation  essentially operated mediationally through the latter behavioral forms of self-efficacy rather than directly on prosocial behavior , delinquent conduct , and depression . Perceived empathic self-efficacy functioned as a generalized contributor to psychosocial functioning . It was accompanied by prosocial behavior and low involvement in delinquency but increased vulnerability to depression in adolescent females Parents and teachers of children with special needs face unique social-emotional challenges in carrying out their caregiving roles . Stress associated with these roles impacts parents ' and special educators ' health and well-being , as well as the quality of their parenting and teaching . No rigorous studies have assessed whether mindfulness training ( MT ) might be an effective strategy to reduce stress and cultivate well-being and positive caregiving in these adults . This r and omized controlled study assessed the efficacy of a 5-week MT program for parents and educators of children with special needs . Participants receiving MT showed significant reductions in stress and anxiety and increased mindfulness , self-compassion , and personal growth at program completion and at 2 months follow-up in contrast to waiting-list controls . Relational competence also showed significant positive changes , with medium-to-large effect sizes noted on measures of empathic concern and forgiveness . MT significantly influenced caregiving competence specific to teaching . Mindfulness changes at program completion mediated outcomes at follow-up , suggesting its importance in maintaining emotional balance and facilitating well-being in parents and teachers of children with developmental challenges Cultivating Awareness and Resilience in Education ( CARE for Teachers ) is a mindfulness-based professional development program design ed to reduce stress and improve teachers ' performance and classroom learning environments . A r and omized controlled trial examined program efficacy and acceptability among a sample of 50 teachers r and omly assigned to CARE or waitlist control condition .  Participants completed a battery of self-report measures at pre- and postintervention to assess the impact of the CARE program on general well-being , efficacy , burnout/time pressure , and mindfulness . Participants in the CARE group completed an evaluation of the program after completing the intervention . ANCOVAs were computed between the CARE group and control group for each outcome , and the pretest scores served as a covariate . Participation in the CARE program result ed in significant improvements in teacher well-being , efficacy , burnout/time-related stress , and mindfulness compared with controls . Evaluation data showed that teachers viewed CARE as a feasible , acceptable , and effective method for reducing stress and improving performance . Results suggest that the CARE program has promise to support teachers working in challenging setting s and consequently improve classroom environments 
    Output:
    
MBIs showed strongest promise for intermediary effects on teacher emotion regulation .
The results of the review are discussed in the context of a model of teacher stress .
Teacher social and emotional competence has implication s for pupil wellbeing through teacher – pupil relationships and effective management of the classroom .