***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: OBJECTIVES The aim of these two studies was to evaluate the effectiveness of the Mindful Self-Compassion ( MSC ) program , an 8-week workshop design ed to train people to be more self-compassionate . METHODS Study 1 was a pilot study that examined change scores in self-compassion , mindfulness , and various wellbeing outcomes among community adults ( N = 21 ; mean [ M ] age = 51.26 , 95 % female ) . Study 2 was a r and omized controlled trial that compared a  treatment group ( N = 25 ; M age = 51.21 ; 78 % female ) with a waitlist control group ( N = 27 ; M age = 49.11 ; 82 % female ) . RESULTS Study 1 found significant pre/post gains in self-compassion , mindfulness , and various wellbeing outcomes . Study 2 found that compared with the control group , intervention participants reported significantly larger increases in self-compassion , mindfulness , and wellbeing . Gains were maintained at 6-month and 1-year follow-ups . CONCLUSIONS The MSC program appears to be effective at enhancing self-compassion , mindfulness , and wellbeing The ability to accurately infer others ' mental states from facial expressions is important for optimal social functioning and is fundamentally impaired in social cognitive disorders such as autism . While pharmacologic interventions have shown promise for enhancing empathic accuracy , little is known about the effects of behavioral interventions on empathic accuracy and related brain activity . This study employed a r and omized , controlled and longitudinal design to investigate the effect of a secularized analytical compassion meditation program , cognitive-based compassion training ( CBCT ) , on empathic accuracy . Twenty-one healthy participants received functional MRI scans while completing an  empathic accuracy task , the Reading the Mind in the Eyes Test ( RMET ) , both prior to and after completion of either CBCT or a health discussion control group . Upon completion of the study interventions , participants r and omized to CBCT and were significantly more likely than control subjects to have increased scores on the RMET and increased neural activity in the inferior frontal gyrus ( IFG ) and dorsomedial prefrontal cortex ( dmPFC ) . Moreover , changes in dmPFC and IFG activity from baseline to the post-intervention assessment were associated with changes in empathic accuracy . These findings suggest that CBCT may hold promise as a behavioral intervention for enhancing empathic accuracy and the neurobiology supporting it Recent empirical evidence supports the importance of adequate r and omization in controlled trials . Trials with inadequate allocation concealment have been associated with larger treatment effects compared with trials in which authors reported adequate allocation concealment . While that provides empirical evidence of bias being interjected into trials , trial investigators rarely document the sensitive details of subverting the intended purpose of r and omization . This article relates anonymous accounts run the gamut from simple to intricate operations , from transillumination of envelopes to search ing for code in the office files of the principal investigator . They indicate that deciphering is something more frequent than a rate occurrence . These accounts prompt some method ological recommendations to help prevent deciphering . R and omized controlled trials appear to annoy human nature -- if properly conducted , indeed they should Conditional goal setting ( CGS , the tendency to regard high order goals such as happiness , as conditional upon the achievement of lower order goals ) is observed in individuals with depression and recent research has suggested a link between levels of dispositional mindfulness and conditional goal setting in depressed patients . Since interventions which aim to increase mindfulness through training in meditation are used with patients suffering from depression it is of interest to examine whether such interventions might alter CGS . Study 1 examined the correlation between changes in dispositional mindfulness and changes in CGS over a 3 - 4 month period in patients participating in a pilot r and omised controlled trial of Mindfulness-Based Cognitive Therapy ( MBCT ) .  Results indicated that increases in dispositional mindfulness were significantly associated with decreases in CGS , although this effect could not be attributed specifically to the group who had received training in meditation . Study 2 explored the impact of brief periods of either breathing or loving kindness meditation on CGS in 55 healthy participants . Contrary to expectation , a brief period of meditation increased CGS . Further analyses indicated that this effect was restricted to participants low in goal re-engagement ability who were allocated to loving kindness meditation . Longer term changes in dispositional mindfulness are associated with reductions in CGS in patients with depressed mood . However initial reactions to meditation , and in particular loving kindness meditation , may be counterintuitive and further research is required in order to determine the relationship between initial reactions and longer-term benefits of meditation practice B. L. Fredrickson 's ( 1998 , 2001 ) broaden- and -build theory of positive emotions asserts that people 's daily experiences of positive emotions compound over time to build a variety of consequential personal re sources . The authors tested this build hypothesis in a field experiment with working adults ( n = 139 ) , half of whom were r and omly-assigned to begin a practice of loving-kindness meditation .  Results showed that this meditation practice produced increases over time in daily experiences of positive emotions , which , in turn , produced increases in a wide range of personal re sources ( e.g. , increased mindfulness , purpose in life , social support , decreased illness symptoms ) . In turn , these increments in personal re sources predicted increased life satisfaction and reduced depressive symptoms . Discussion centers on how positive emotions are the mechanism of change for the type of mind-training practice studied here and how loving-kindness meditation is an intervention strategy that produces positive emotions in a way that outpaces the hedonic treadmill effect Meditation practice s may impact physiological pathways that are modulated by stress and relevant to disease . While much attention has been paid to meditation practice s that emphasize calming the mind , improving focused attention , or developing mindfulness , less is known about meditation practice s that foster compassion . Accordingly , the current study examined the effect of compassion meditation on innate immune , neuroendocrine and behavioral responses to psychosocial stress and evaluated the degree to which engagement in meditation practice influenced stress reactivity .  Sixty-one healthy adults were r and omized to 6 weeks of training in compassion meditation ( n=33 ) or participation in a health discussion control group ( n=28 ) followed by exposure to a st and ardized laboratory stressor ( Trier social stress test [ TSST ] ) . Physiologic and behavioral responses to the TSST were determined by repeated assessment s of plasma concentrations of interleukin (IL)-6 and cortisol as well as total distress scores on the Profile of Mood States ( POMS ) . No main effect of group assignment on TSST responses was found for IL-6 , cortisol or POMS scores . However , within the meditation group , increased meditation practice was correlated with decreased TSST-induced IL-6 ( r(p)=-0.46 , p=0.008 ) and POMS distress scores ( r(p)=-0.43 , p=0.014 ) . Moreover , individuals with meditation practice times above the median exhibited lower TSST-induced IL-6 and POMS distress scores compared to individuals below the median , who did not differ from controls . These data suggest that engagement in compassion meditation may reduce stress-induced immune and behavioral responses , although future studies are required to determine whether individuals who engage in compassion meditation techniques are more likely to exhibit reduced stress reactivity Decentering has been proposed as a potential mechanism of mindfulness-based interventions but has received limited empirical examination to date in experimental studies comparing mindfulness meditation to active comparison conditions . In the present study , we compared the immediate effects of mindful breathing ( MB ) to two alternative stress-management techniques : progressive muscle relaxation ( PMR ) and loving-kindness meditation ( LKM ) to test whether decentering is unique to mindfulness meditation or common across approaches . Novice meditators ( 190 female undergraduates ) were r and omly assigned to complete one of three 15-min stress-management exercises ( MB , PMR , or LKM ) presented by audio recording . Immediately after the exercise , participants completed measures of decentering , frequency of repetitive thoughts during the exercise , and degree of negative reaction to thoughts . As predicted , participants in the MB condition reported greater decentering relative to the other two conditions . The association between frequency of repetitive thought and negative reactions to thoughts was relatively weaker in the MB condition than in the PMR and LKM conditions , in which these two variables were strongly and positively correlated . Consistent with the construct of decentering , the relative independence between these two variables in the MB condition suggests that mindful breathing may help to reduce reactivity to repetitive thoughts . Taken together , results help to provide further evidence of decentering as a potential mechanism that distinguishes mindfulness practice from other credible stress-management approaches Flaws in the design , conduct , analysis , and reporting of r and omised trials can cause the effect of an intervention to be underestimated or overestimated . The Cochrane Collaboration ’s tool for assessing risk of bias aims to make the process clearer and more This pilot study examined loving-kindness meditation ( LKM ) with 18 participants with schizophrenia-spectrum disorders and significant negative symptoms . Findings indicate that the intervention was feasible and associated with decreased negative symptoms and increased positive emotions and psychological recovery Most studies of meditation have focused on " actual affect " ( how people actually feel ) . We predict that meditation may even more significantly alter " ideal affect " ( how people ideally want to feel ) . As predicted , meditators ideally wanted to feel calm more and excited less than nonmeditators , but the groups did not differ in their actual experience of calm or excited states ( Study 1 ) . We ruled out self- selection and nonspecific effects by r and omly assigning participants to meditation classes , an improvisational theater class , or a no class control ( Study 2 ) . After eight weeks , meditators valued calm more but did not differ in their actual experience of calm compared with the other groups . There were no differences in ideal or actual excitement , suggesting that meditation selectively increases the value placed on calm . These findings were not due to expectancy effects ( Study 3 ) . We discuss the implication s of these findings for underst and ing how meditation alters affective life Objective To evaluate the reliability of risk of bias assessment s based on published trial reports , for determining trial inclusion in meta-analyses . Design Reliability evaluation of risk of bias assessment s. Data sources 13 published individual participant data ( IPD ) meta-analyses in cancer were used to source 95 r and omised controlled trials . Review methods Risk of bias was assessed using the Cochrane risk of bias tool ( RevMan5.1 ) and accompanying guidance . Assessment s were made for individual risk of bias domains and overall for each trial , using information from either trial reports alone or trial reports with additional information collected for IPD meta-analyses . Percentage agreements were calculated for individual domains and overall ( < 66%=low , ≥66%=fair , ≥90%=good ) . The two approaches were considered similarly reliable only when agreement was good . Results Percentage agreement between the two methods for sequence generation and incomplete outcome data was fair ( 69.5 % ( 95 % confidence interval 60.2 % to 78.7 % ) and 80.0 % ( 72.0 % to 88.0 % ) , respectively ) . However , percentage agreement was low for allocation concealment , selective outcome reporting , and overall risk of bias ( 48.4 % ( 38.4 % to 58.5 % ) , 42.1 % ( 32.2 % to 52.0 % ) , and 54.7 % ( 44.7 % to 64.7 % ) , respectively ) . Supplementary information reduced the proportion of unclear assessment s for all individual domains , consequently increasing the number of trials assessed as low risk of bias ( and therefore available for inclusion in meta-analyses ) from 23 ( 23 % ) based on publications alone to 66 ( 66 % ) based on publications with additional information . Conclusions Using cancer trial publications alone to assess risk of bias could be unreliable ; thus , review ers should be cautious about using them as a basis for trial inclusion , particularly for those trials assessed as unclear risk . Supplementary information from trialists should be sought to enable appropriate assessment s and potentially reduce or overcome some risks of bias . Furthermore , guidance should ensure clarity on what constitutes risk of bias , particularly for the more subjective domains BACKGROUND A growing body of research shows that mindfulness meditation can alter neural , behavioral and biochemical processes . However , the mechanisms responsible for such clinical ly relevant effects remain elusive . METHODS Here we explored the impact of a day of intensive practice of  mindfulness meditation in experienced subjects ( n=19 ) on the expression of circadian , chromatin modulatory and inflammatory genes in peripheral blood mononuclear cells ( P BMC ) . In parallel , we analyzed a control group of subjects with no meditation experience who engaged in leisure activities in the same environment ( n=21 ) . P BMC from all participants were obtained before ( t1 ) and after ( t2 ) the intervention ( t2-t1=8h ) and gene expression was analyzed using custom pathway focused quantitative-real time PCR assays . Both groups were also presented with the Trier Social Stress Test ( TSST ) . RESULTS Core clock gene expression at baseline ( t1 ) was similar between groups and their rhythmicity was not influenced in meditators by the intensive day of practice . Similarly , we found that all the epigenetic regulatory enzymes and inflammatory genes analyzed exhibited similar basal expression levels in the two groups . In contrast , after the brief intervention we detected reduced expression of histone deacetylase genes ( HDAC 2 , 3 and 9 ) , alterations in global modification of histones ( H4ac ; H3K4me3 ) and decreased expression of pro-inflammatory genes ( RIPK2 and COX2 ) in meditators compared with controls . We found that the expression of RIPK2 and HDAC2 genes was associated with a faster cortisol recovery to the TS 
    Output:
    
Exposure to KBM may initially be challenging for some people .
RESULTS were inconclusive for some outcomes , in particular against active controls .
KBM showed evidence of benefits for the health of individuals and communities through its effects on well-being and social interaction .