***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 study is to describe the essential features of the transformative experience among people living with cancer who are seeking integrative care and to identify factors supporting this process . It is hoped that after establishing the nature and meaning of this change or shift , one will better underst and what is most meaningful in terms of providing appropriate care and support to patients seeking integrative care . Study Design . An interpretational , qualitative approach guided sampling , data collection , and analysis with 11 individuals . A purpose ful sample was drawn from selected integrative care facilities according to sociodemographics and type of cancer . Due to the complexity of this subject , second interviews were conducted with 5 participants to enhance the richness and validity of the data . Results . The experience of transformation is a dynamic 4-stage process in which participants learned about themselves and became more aware of who they are and how they relate to the world . Participants found that 4 dimensions of integrative medicine played a fundamental role in supporting this process . These dimensions include ( 1 ) having access to a range of appropriate therapies to support individual journeys , ( 2 ) care that focuses on one ’s overall well-being , ( 3 ) control over cancer management , and ( 4 ) developing healing relationships with care providers . Conclusion . Although practitioners may not be able to create transformative experiences for patients , they may be able to establish and maintain conditions that support this process The existing review s of massage therapy ( MT ) research are either limited to infants , adults , or were conducted prior to the publication of the most recent studies using pediatric sample s. R and omized controlled trials ( RCTs ) of pediatric MT are review ed . A literature search yielded 24 RCTs of pediatric MT  , defined as the manual manipulation of soft tissue intended to promote health and well-being in recipients between 2 and 19 years of age . Because RCTs of pediatric MT varied considerably in the amount and types of data reported , quantitative and narrative review methods were both used . Singledose and multiple-dose effects were examined separately . Among single-dose effects , significant reductions of state anxiety were observed at the first session ( g 1⁄4 0.59 , P < 0.05 ) and the last session ( g 1⁄4 1.10 , P < 0.01 ) of a course of treatment . Effects for salivary cortisol ( g 1⁄4 0.28 ) , negative mood ( g 1⁄4 0.52 ) and behavior ( g 1⁄4 0.37 ) were non-significant . Three of eleven multiple-dose effects were statistically significant . These were trait anxiety ( g 1⁄4 0.94 , P < 0.05 ) , muscle tone ( g 1⁄4 0.90 , P < 0.01 ) and arthritis pain ( g1⁄4 1.33 , P < 0.01 ) . Results of studies not permitting effect size calculation were judged to be generally consistent with quantitative results . MT benefits pediatric recipients , though not as universally as sometimes reported . Numerous weaknesses endemic to MT research ( e.g. low statistical power , frequent failure to report basic descriptive statistics ) are identified , and recommendations for future pediatric MT research are discussed Background : Many common medical , surgical , and diagnostic procedures performed for conscious patients can be accompanied by significant anxiety .  Mind-body-spirit interventions could serve as useful adjunctive treatments for the reduction of stress . Objective : To evaluate the effects of stress management , imagery , touch therapy , remote intercessory prayer , and st and ard therapy on mood in patients awaiting percutaneous interventions for unstable coronary syndromes as part of the Monitoring and Actualization of Noetic Training ( MANTRA ) trial , which explored the feasibility and efficacy of noetic interventions on clinical outcomes in a r and omized clinical trial . Methods : A total of 150 patients were r and omized to one of the five treatment conditions .  Stress management , imagery , and touch therapy were administered in 30-minute treatment sessions immediately before the cardiac intervention . Intercessory prayer was not necessarily contemporaneous with these treatments . Mood was assessed by a set of visual analog scales before and after treatment for a similar length of time for the st and ard therapy and prayer groups . Results : Analysis of complete data from 108 patients showed that stress management , imagery , and touch therapy all produced reductions in reported worry , as compared with st and ard therapy , whereas remote intercessory prayer had no effect on mood . The ratings of other similar moods were not affected , perhaps because of the relatively positive emotional state observed in the participants before treatment . Conclusions : The results suggest that at least some noetic therapies may have beneficial effects on mood in the course of medical and surgical interventions . Administration of these interventions was feasible even in the hectic environment of the coronary intensive care unit . Given their relatively low cost and limited potential for adverse effects , these interventions merit further study as therapeutic adjuncts Background Research ers are finding limitations of currently available disease-focused question naire tools for outcome studies in complementary and alternative medicine/integrative medicine ( CAM/IM ) . Methods Three sub studies investigated the new one-item visual  analogue Arizona Integrative Outcomes Scale ( AIOS ) , which assesses self-rated global sense of spiritual , social , mental , emotional , and physical well-being over the past 24 hours and the past month . The first study tested the scale 's ability to discriminate unhealthy individuals ( n = 50 ) from healthy individuals ( n = 50 ) in a rehabilitation outpatient clinic sample . The second study examined the concurrent validity of the AIOS by comparing ratings of global well-being to degree of psychological distress as measured by the Brief Symptom Inventory ( BSI ) in undergraduate college students ( N = 458 ) . The third study evaluated the relationships between the AIOS and positively- and negatively-valenced tools ( Positive and Negative Affect Scale and the Positive States of Mind Scale ) in a different sample of undergraduate students ( N = 62 ) . Results Sub study ( i ) Rehabilitation patients scored significantly lower than the healthy controls on both forms of the AIOS and a current global health rating . The AIOS 24-hours correlated moderately and significantly with global health ( patients r = 0.50 ; controls r = 0.45 ) . AIOS 1-month correlations with global health were stronger within the controls ( patients r = 0.36 ; controls r = 0.50 ) . Controls ( r = 0.64 ) had a higher correlation between the AIOS 24-hour and 1-month forms than did the patients ( r = 0.33 ) , which is consistent with the presumptive improvement in the patients ' condition over the previous 30 days in rehabilitation . Sub study ( ii ) In undergraduate students , AIOS scores were inversely related to distress ratings , as measured by the global severity index on the BSI ( rAIOS24h = -0.42 , rAIOS1month = -0.40 ) . Sub study ( iii ) AIOS scores were significantly correlated with positive affect ( rAIOS24h = 0.56 , rAIOS1month = 0.57 ) and positive states of mind ( rAIOS24h = 0.42 , rAIOS1month = 0.45 ) , and inversely correlated with negative affect ( rAIOS24h = -0.41 , rAIOS1month = -0.59 ) . Conclusions The AIOS is able to distinguish relatively sicker from relatively healthier individuals ; and correlates in expected directions with a measure of distress and indicators of positive and negative affect and positive states of mind . The AIOS offers a tool for CAM/IM research that extends beyond a disease emphasis BACKGROUND Data from a pilot study suggested that noetic therapies-healing practice s that are not mediated by tangible elements-can reduce preprocedural distress and might affect outcomes in patients undergoing percutaneous coronary intervention . We undertook a multicentre , prospect i ve trial of two such practice s : intercessory prayer and music , imagery , and touch ( MIT ) therapy . METHODS 748 patients undergoing percutaneous coronary intervention or elective catheterisation in nine USA centres were assigned in a 2x2 factorial r and omisation either off-site prayer by established congregations of various religions or no off-site prayer ( double-blinded ) and MIT therapy or none ( unmasked ) . The primary endpoint was combined in-hospital major adverse cardiovascular events and 6-month readmission or death . Prespecified secondary endpoints were 6-month major adverse cardiovascular events , 6 month death or readmission , and 6-month mortality . FINDINGS 371 patients were assigned prayer and 377 no prayer ; 374 were assigned MIT therapy and 374 no MIT therapy . The factorial distribution was : st and ard care only , 192 ; prayer only , 182 ; MIT therapy only , 185 ; and both prayer and MIT therapy , 189 . No significant difference was found for the primary composite endpoint in any treatment comparison . Mortality at 6 months was lower with MIT therapy than with no MIT therapy ( hazard ratio 0.35 ( 95 % CI 0.15 - 0.82 , p=0.016 ) . INTERPRETATION Neither masked prayer nor MIT therapy significantly improved clinical outcome after elective catheterisation or percutaneous coronary intervention Abstract BACKGROUND : Integrative medicine is an individualized , patient-centered approach to health , combining a whole-person model with evidence -based medicine . Interventions based in integrative medicine theory have not been tested as cardiovascular risk-reduction strategies . Our objective was to determine whether personalized health planning ( PHP ) , an intervention based on the theories and principles underlying integrative medicine , reduces 10-year risk of coronary heart disease ( CHD ) . METHODS : We conducted a r and omized , controlled trial among 154 out patients age 45 or over , with 1 or more known cardiovascular risk factors . Subjects were enrolled from primary care practice s near an academic medical center , and the intervention was delivered at a university Center for Integrative Medicine . Following a health risk assessment , each subject in the intervention arm worked with a health coach and a medical provider to construct a personalized health plan . The plan identified specific health behaviors important for each subject to modify ; the choice of behaviors was driven both by cardiovascular risk reduction and the interests of each individual subject . The coach then assisted each subject in implementing her/his health plan . Techniques used in implementation included mindfulness meditation , relaxation training , stress management , motivational techniques , and health education and coaching .  Subjects r and omized to the comparison group received usual care ( UC ) without access to the intervention  . Our primary outcome measure was 10-year risk of CHD , as measured by a st and ard Framingham risk score , and assessed at baseline , 5 , and 10 months . Differences between arms were assessed by linear mixed effects modeling , with time and study arm as independent variables . RESULTS : Baseline 10-year risk of CHD was 11.1 % for subjects r and omized to UC ( n=77 ) , and 9.3 % for subjects r and omized to PHP ( n=77 ) . Over 10 months of the intervention , CHD risk decreased to 9.8 % for UC subjects and 7.8 % for intervention subjects . Based on a linear mixed-effects model , there was a statistically significant difference in the rate of risk improvement between the 2 arms ( P=.04 ) . In secondary analyses , subjects in the PHP arm were found to have increased days of exercise per week compared with UC ( 3.7 vs 2.4 , P=.002 ) , and subjects who were overweight on entry into the study had greater weight loss in the PHP arm compared with UC ( P=.06 ) . CONCLUSIONS : A multidimensional intervention based on integrative medicine principles reduced risk of CHD , possibly by increasing exercise and improving weight loss The aim of the present study , which is part of a major clinical controlled study of the life situation of women with breast cancer , was to compare two groups of women concerning perceived quality of life and coping . The women were treated in two different cancer treatment programs : complementary treatment , which included anthroposophic therapy , and conventional cancer treatment . A total of 120 women were included , 60 women treated with anthroposophic medicine , and 60 individually matched women treated with conventional medicine only .  Quality of life was measured by the European Organization for Research and Treatment of Cancer , Quality of Life Question naire , Core 30 , and the Life Satisfaction Question naire . Coping was measured by the Mental Adjustment to Cancer scale . The results showed that the women who chose anthroposophic therapy perceived their quality of life to be lower on admission to the hospital and showed more anxious preoccupation than the women in conventional medicine . It can be concluded that , due to the careful matching procedure , the women in the two groups are comparable in a medical sense but not from the perspective of quality of life and coping BACKGROUND Patients undergoing percutaneous coronary intervention ( PCI ) for unstable coronary syndromes have substantial emotional and spiritual distress that may promote procedural complications . Noetic ( nonpharmacologic ) therapies may reduce anxiety , pain and distress , enhance the efficacy of pharmacologic agents , or affect short- and long-term procedural outcomes . METHODS The Monitoring and Actualization of Noetic Training ( MANTRA ) pilot study examined the feasibility of applying 4 noetic therapies-stress relaxation , imagery , touch therapy , and prayer-to  patients in the setting of acute coronary interventions . Eligible patients had acute coronary syndromes and invasive angiography or PCI . Patients were r and omized across 5 treatment groups : the 4 noetic and st and ard therapies . Question naires completed before PCI reflected patients ' religious beliefs and anxiety . Index hospitalization end points included post-PCI ischemia , death , myocardial infa rct ion , heart failure , and urgent revascularization . Mortality was followed up for 6 months after hospitalization . R 
    Output:
    
These studies provide limited evidence of effective integrative health care on some modalities .
However , integrative health care regimen appears to be generally safe