***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: OBJECTIVE We tested the effects of a 10-week group-based cognitive-behavioral stress management/expressive-supportive therapy intervention ( CBSM+ ) and a time-matched individual psychoeducational condition for 330 women with AIDS reporting moderate to poor baseline quality of life ( QOL ) .  The goal of this study was to examine treatment effects on total QOL and 11 QOL domains from baseline to post-intervention follow-up . METHODS Participants were assessed at baseline , r and omized to a treatment condition ( individual psychoeducation condition n=180 , group-based CBSM+ condition n=150 ) , participated in the intervention for 10 weeks and assessed again within 4 weeks following the intervention .  QOL was measured using the Medical Outcomes Study -HIV-30 . RESULTS QOL scores increased over the course of both interventions for the total QOL score and three QOL domains : cognitive functioning , health distress and overall health perceptions . While women in the CBSM+ group condition showed a significant improvement in mental health QOL from pre- to post-intervention , women in the individual condition did not change . No changes were observed for energy/fatigue , health transition , single-item overall QOL , pain , physical well-being , role functioning or social functioning in either condition . CONCLUSION Results suggest that group-based CBSM+ and individual psychoeducational interventions are effective at improving certain aspects of QOL and that group-based CBSM+ may be particularly effective at increasing QOL related to mental health in this population of women with AIDS Background Stress management interventions can reduce symptoms of distress as well as modulate certain immune system components in persons infected with human immunodeficiency virus ( HIV ) . These effects may occur in parallel with reductions in hypothalamic-pituitary-adrenal ( HPA ) axis hormones such as cortisol , which has been related in other work to a down-regulation of immune system components relevant to HIV infection . The present study tested the effects of a multimodal cognitive-behavioral stress management ( CBSM ) intervention on 24-hour urinary free cortisol levels and distressed mood in symptomatic HIV+ gay men . Methods Symptomatic HIV-infected gay men who were r and omized to either a 10-week group-based CBSM intervention or a 10-week wait-list period provided psychological responses and urine sample s pre-post intervention . Results Of the 59 participants providing matched question naire data , men assigned to CBSM ( n=40 ) showed significantly lower posttreatment levels of self-reported depressed affect , anxiety , anger , and confusion than those in the wait-list control group ( n=19 ) . Among the 47 men providing urine sample s ( 34 CBSM , 13 controls ) , those assigned to CBSM revealed significantly less cortisol output as compared to controls . At the individual level , depressed mood decreases paralleled cortisol reductions over this period across the entire sample . Conclusion A time-limited CBSM intervention reduced distress symptoms and urinary free cortisol output in symptomatic HIV+ gay men and greater reductions in some aspects of distress , especially depressed mood , paralleled greater decreases in cortisol over the intervention period . If persisting stressors and depressed mood contribute to chronic HPA axis activation in HIV-infected persons , then interventions such as CBSM , which teaches them to relax , alter cognitive appraisal s , use new coping strategies , and access social support re sources , may decrease distress and depressed mood and normalize HPA axis functioning We wished to determine the short-term safety and efficacy of a Chinese medicinal herb preparation in treating symptoms of human immunodeficiency virus ( HIV ) infection in a 12-week r and omized , double-blind , placebo-controlled clinical trial in a University-affiliated acquired immunodeficiency syndrome ( AIDS ) clinic at a public general hospital . Thirty adults with symptomatic HIV infection , no previous AIDS-defining diagnosis , and CD4 + counts of 0.200 - 0.499 x 10(9)/L ( 200 - 499/mm3 ) received 28 tablets each day of either a st and ardized oral preparation of 31 Chinese herbs or a cellulose placebo . Primary outcome measures were changes in life satisfaction , perceived health , and number and severity of symptoms . Other outcomes included adherence , and changes in weight , CD4 + count , depression , anxiety , physical and social function , and mental health . Two placebo- and no herb-treated subjects had mild adverse events ( AE ) . Subjects on both arms reported taking 94 % of prescribed tablets . No differences between treatment groups reached the p < 0.05 level . Life satisfaction improved in herb-treated [ + 0.86 , 95 % confidence interval ( CI ) : + 0.29 , + 1.43 ] but not in placebo-treated subjects ( + 0.20 , 95 % CI -0.35 , + 0.75 ) . Number of symptoms was reduced in subjects receiving herbs ( -2.2 , 95 % CI -4.1 , -0.3 ) but not in those receiving placebo ( -0.3 , 95 % CI -3.2 , + 2.7 ) . There were trends toward greater improvements among herb-treated subjects on all symptom subscales except dermatologic . Believing that one was receiving herbs was strongly associated with reporting that the treatment had helped ( p < 0.005 ) , but not with changes in life satisfaction or symptoms . There were improvements in life satisfaction and symptoms among subjects receiving the herbal therapy . Whether Chinese herbs are effective in the management of symptomatic HIV infection can be adequately addressed only by larger trials of longer duration Assigned r and omly 28 neonates born to HIV-positive mothers to a massage therapy  or control group . The treatment infants were given three 15-minute massages daily for 10 days . The massaged group showed superior performance on almost every Brazelton newborn cluster score and had a greater daily weight gain at the end of the treatment period unlike the control group who showed declining performance CONTEXT Peripheral neuropathy is common in persons infected with the human immunodeficiency virus ( HIV ) but few data on symptomatic treatment are available . OBJECTIVE To evaluate the efficacy of a st and ardized acupuncture regimen ( SAR ) and amitriptyline hydrochloride for the relief of pain due to HIV-related peripheral neuropathy in HIV-infected patients . DESIGN R and omized , placebo-controlled , multicenter clinical trial . Each site enrolled patients into 1 of the following 3 options : ( 1 ) a modified double-blind 2 x 2 factorial design of SAR , amitriptyline , or the combination compared with placebo , ( 2 ) a modified double-blind design of an SAR vs control points , or ( 3 ) a double-blind design of amitriptyline vs placebo . SETTING Terry Beirn Community Programs for Clinical Research on AIDS ( HIV primary care providers ) in 10 US cities . PATIENTS Patients with HIV-associated , symptomatic , lower-extremity peripheral neuropathy . Of 250 patients enrolled , 239 were in the acupuncture comparison ( 125 in the factorial option and 114 in the SAR option vs control points option ) , and 136 patients were in the amitriptyline comparison ( 125 in the factorial option and 11 in amitriptyline option vs placebo option ) . INTERVENTIONS St and ardized acupuncture regimen vs control points , amitriptyline ( 75 mg/d ) vs placebo , or both for 14 weeks . MAIN OUTCOME MEASURE Changes in mean pain scores at 6 and 14 weeks , using a pain scale ranging from 0.0 ( no pain ) to 1.75 ( extremely intense ) , recorded daily . RESULTS Patients in all 4 groups showed reduction in mean pain scores at 6 and 14 weeks compared with baseline values . For both the acupuncture and amitriptyline comparisons , changes in pain score were not significantly different between the 2 groups . At 6 weeks , the estimated difference in pain reduction for patients in the SAR group compared with those in the control points group ( a negative value indicates a greater reduction for the " active " treatment ) was 0.01 ( 95 % confidence interval [ CI ] , -0.11 to 0.12 ; P=.88 ) and for patients in the amitriptyline group vs those in the placebo group was -0.07 ( 95 % CI , -0.22 to 0.08 ; P=.38 ) . At 14 weeks , the difference for those in the SAR group compared with those in the control points group was -0.08 ( 95 % CI , -0.21 to 0.06 ; P=.26 ) and for amitriptyline compared with placebo was 0.00 ( 95 % CI , -0.18 to 0.19 ; P=.99 ) . CONCLUSIONS In this study , neither acupuncture nor amitriptyline was more effective than placebo in relieving pain caused by HIV-related peripheral neuropathy CONTEXT Alternative medicine or complementary remedies that have not been scientifically tested are nonetheless widely used to treat chronic illnesses , particularly if curative options are limited . OBJECTIVES To assess the effectiveness of Chinese medicinal herbs in reducing symptoms and improving the quality of life of  HIV-infected persons . DESIGN Prospect i ve , placebo-controlled double-blind study . SETTING University-based HIV outpatient clinic . PATIENTS 68 HIV-infected adults with CD4 cell counts < 0.5 x 10(9)/L. INTERVENTION Participants were r and omized to receive four daily doses of seven pills containing a st and ardized preparation of 35 Chinese herbs or placebo for 6 months . MAIN OUTCOME MEASURES Symptoms , HIV disease progression , HIV-1 RNA plasma viral loads , CD4 and CD8 cell counts , and scores on st and ard question naires for quality of life , depression , anxiety , and coping . RESULTS Intervention and placebo groups were equivalent at baseline regarding , respectively , previous antiretroviral therapy ( 74 % versus 79 % ) , median CD4 cell counts ( 0.20 x 10(9)/L versus 0.25 x 10(9)/L ) , and median HIV-1 plasma viral loads ( 35,612 copies/ml versus 52,027 copies/ml ) . At enrollment , none of the study subjects was seriously ill or depressed , and average coping and quality of life scores were in the normal range . In all , 53 ( 78 % ) participants completed the study . Patients taking Chinese herbs reported significantly more gastrointestinal disturbances ( 79 % versus 38 % ; p = .003 ) than those receiving placebo . No therapy-related toxicities were observed . At completion of the study , no significant differences between the intervention and placebo groups were found regarding plasma viral loads , CD4 cell counts , symptoms , and psychometric parameters . HIV-1 RNA level was unchanged at study end . Among participants who were not on concomitant antiretroviral therapy , median CD4 cell counts declined by 0.05 x 10(9)/L in both the intervention and placebo groups . CONCLUSIONS This st and ardized formulation of Chinese herbs for HIV-infected individuals did not improve quality of life , clinical manifestations , plasma virus loads , or CD4 cell counts . The data suggest that this formulation of Chinese herbs is not effective when administered in a Western medicine setting In this pilot study , 20 HIV-infected children , 6 to 12 years of age , were r and omly assigned into therapeutic touch ( TT ) and mimic TT groups . The effectiveness of TT in reducing anxiety was evaluated . The self-report measure , the A-State Anxiety subscale of the Spielberger State-Trait Anxiety Inventory For Children , was administered before and immediately after interventions . As predicted , the TT intervention result ed in lower overall mean anxiety scores , whereas the mimic TT did not . These findings provide preliminary support for the use of TT in reducing the state anxiety of children with HIV infection This study tested the effects of a 7-week individual self-management and coping skills training program on various measures of health and well-being of persons with HIV/AIDS . Forty men and women were r and omly assigned the treatment or wait-list control group . Treated participants showed significant posttreatment changes on all four major measures of mood , coping , and health attitudes . Treatment significantly improved coping strategies as measured by the use and effective measures of the Jalowiec Coping Scale and several of its subscales , including decreases in use of emotive , fatalistic , and palliative coping styles . Psychological mood was improved , as measured by the Profile of Moods Total Mood Disturbance ( POMS TMD ) score and specific subscales of the POMS , which were targeted in the intervention ( e.g. , Anger ) . Treated participants also showed significant increases on the Internal subscale of the Health Attribution Test Twenty-nine gay men ( 20 HIV+ , 9 HIV- ) received daily massages for one month . A subset of 11 of the HIV+ subjects served as a within subject control group ( one month with and without massages ) . Major immune findings for the effects of the month of massage included a significant increase in Natural Killer Cell number , Natural Killer Cell Cytotoxicity , soluble CD8 , and the cytotoxic subset of CD8 cells . There were no changes in HIV disease progression markers ( CD4 , CD4/CD8 ratio , Beta-2 microglobulin , neopterin ) . Major 
    Output:
    
The results suggest that stress management may prove to be an effective way to increase the quality of life .
For all other treatments , data are insufficient for demonstrating effectiveness .