***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: Twenty army officers who participated in a stress/type A behavior reduction program  and a comparison group of 17 officer non participants  volunteered to undergo a battery of psychological and behavioral tests before and after the program . Following the program , participants displayed a significantly greater reduction in average daily caloric intake and levels of perceived stress , anxiety , hostility , depression , psychological distress , and type A behavior as compared to the officers who did not participate in it . Given the fact that most of these psychological and behavioral factors have been found in previous studies to be related to an increased risk for coronary artery disease , it seems that the changes reported by the participants in the program are potentially healthful Ninety volunteers in a media organization were r and omly allocated to an Acceptance and Commitment Therapy ( ACT , n = 30 ) group that sought to enhance  people 's  ability to cope with work-related strain , an Innovation Promotion Program ( IPP , n = 30 )  that helped individuals to identify and then innovatively change causes of occupational strain , or a waitlist control group ( n = 30 )  . Both interventions lasted 9 hr , spread over 3 months . Improvements in mental health and work-related variables were found following both interventions . As hypothesized , changes in outcome variables in the ACT condition were mediated only by the acceptance of undesirable thoughts and feelings . In the IPP condition , outcome change was mediated only by attempts to modify stressors . Discussion focused on the importance of underst and ing the mechanisms underpinning change in occupational stress management interventions The effect of a stress management programme as a component of an overall fitness programme was evaluated . Psychological , physiological and economic parameters were examined in relation to stress management activities in an experimental study . Subjects were stratified by life stressors and then r and omly assigned to groups . Stress-related physical symptoms decreased significantly ( P less than 0.05 ) in the treatment group . Those who practised the relaxation techniques regularly had significantly lower systolic blood pressure ( P less than 0.05 ) . Results of cost evaluation demonstrate the benefits from a programme with relatively low overall costs There is a void of studies concerning occupational health aspects from working with the most advanced forms of information technologies techniques such as are found in some of the world-renowned telecommunication systems development laboratories . However , many of these techniques will later be applied in the regular office environment . We wanted to identify some of the major stressors perceived by advanced telecommunication systems design employees and develop a valid and reliable instrument by which to monitor such stressors . We were also interested in assessing the impact of a controlled prospect i ve stress-reduction program on perceived mental stress and specific psychophysiological parameters . A total of 116 employees were recruited . Sixty-one were offered to participate in one of three stress-reduction training programs ( intervention group ) . The additional 50 functioned as a reference group . After a detailed baseline assessment , including a comprehensive question naire and psychophysiological measurements , new assessment s were made at the end of the formal training program ( + 3 months ) and after an additional 5-month period . Results reveal a significant improvement in the intervention group with regard to circulating levels of the stress-sensitive hormone prolactin as well as an attenuation in mental strain . Cardiovascular risk indicators were also improved . Circulating thrombocytes decreased in the intervention group . Type of stress-reduction programs chosen and intensity of participation did not significantly impact results . Coping style was not affected and no beneficial effects were observed with regard to the psychological characteristics of the work , eg intellectual discretion and control over work processes . The survey instrument is now being used in the continuous improvement of work processes and strategic leadership of occupational health issues . The results suggest that prior psychophysiological stress research , based on low- and medium-skill , rather repetitive kinds of jobs , may not be completely applicable to that of skilled professionals . The results indicate that cutting-edge telecommunication systems design employees suffer from significant amounts of mental strain . In addition , there are limited but measurable benefits from a stress-reduction program . More attention should be directed as to how to design healthy and productive work environments in workplaces using advanced information technologies A 12-week r and omized experiment investigated the effects of daily relaxation breaks on office workers with " normal " blood pressure . Blood pressures of 126 volunteers from the corporate offices of a manufacturing firm were measured biweekly . After four weeks of baseline monitoring , volunteers were divided r and omly into three groups : Group A was taught a technique for producing the relaxation response ; Group B was " taught " to sit quietly ; and Group C was taught nothing . Groups A and B were asked to take two 15-minute relaxation breaks daily . During the baseline period , mean systolic blood pressures ( SBP ) were 119.7 , 118.4 , and 114.2 for Groups A , B and C respectively ; mean diastolic pressures ( DBP ) were 78.7 and 75.7 Between the first and last measurements , mean changes in SBP were -11.6 , -6.5 , and + 0.4 mm Hg in Groups A , B , and C ; mean DBP decreased by 7.9 , 3.1 , and 0.3 . Between the fourweek baseline period and last four weeks of the experimental period , mean SBP and DBP , mean changes in Group A were significantly greater than those in Group B ( p < 0.05 ) and in Group C ( p < 0.001 ) . The same pattern of changes among the three groups was exhibited by both sexes , all ages , and at all initial levels of blood pressure . However , in general , within Group A , the higher the initial blood pressure , the greater the decrease . ( Am . J. Public Health 67;954 - 959 , 1977 The chief aim of the present study was to investigate the effect of relaxation training on personal adjustment and perceptions of organizational climate . The Stern Activity Index and Organizational Climate Index along with the Bendig Manifest Anxiety Scale were administered to 71 volunteer Ss ( 28 males and 43 females ) as pre- and post-test measures . The Ss were r and omly assigned to three groups , seminar and relaxation training , seminar and a placebo condition , and no treatment . A one-way multivariate analysis showed a significant mean difference . Results obtained from t tests indicated a significant reduction in anxiety and an increase in personal adjustment . Changes in perceptions of organizational climate , although in the predicted direction , were not statistically significant Telework is de central ized computer-mediated performance of work activities at a location distant from the employing organization . In order to improve well-being at such remote workplaces , we developed a health circle ( HC ) concept for teleworkers . Three HC sessions were conducted with a total of 17 teleworkers from diverse organizations and branches . The sessions were moderated by a professional facilitator , while the participants selected the discussion issues . Typical issues were technical problems at the home-based computer , time management , communication with supervisors , colleagues and customers , and feelings of isolation from the main company . Besides discussing these stress factors , participants developed concrete coping strategies based on the exchange of experiences and additional informational input by external experts . Process evaluation at the end of each meeting revealed that participants found the exchange of personal experiences and the informational input during the HCs very helpful , as well as the common development of coping strategies . Moreover , a question naire 2 months after the last HC session revealed that participants reported significantly more positive changes in typical stress factors than teleworkers in a control group . The implication s of these results for preventive and corrective strategies of telework design are discussed An experiment conducted at the corporate offices of a manufacturing firm investigated the effects of daily relaxation breaks on five self-reported measures of health , performance , and well-being . For 12 weeks , 126 volunteers filled out daily records and reported bi-weekly for additional measurements . After four weeks of baseline monitoring , they were divided r and omly into three groups : Group A was taught a technique for producing the relaxation response ; Group B was instructed to sit quiety ; Group C received no instructions . Groups A and B were asked to take two 15-minute relaxation breaks daily . After an eight-week experimental period , the greatest mean improvements on every index occurred in Group A ; the least improvements occurred in Group C ; Group B was intermediate . Differences between the mean changes in Groups A vs C reached statistical significance ( p < 0.05 ) on four of the five indices : Symptoms , Illness Days , Performance , and Sociability-Satisfaction . Improvements on the Happiness-Unhappiness Index were not significantly different among the three groups . The relationship between amount of change and rate of practicing the relaxation response was different for the different indices . While less than three practice periods per week produced little change on any index , two daily sessions appeared to be more practice than was necessary for many individuals to achieve positive changes . Somatic symptoms and performance responded with less practice of the  relaxation response  than did behavioral symptoms and measures of well-being . ( Am . J. Public Health 67:946 - 953,1977 A significant proportion of people entering the military are discharged within the first 6 months of enlistment . Mental health related problems are often cited as the cause of discharge . This study evaluated the utility of stress inoculation training in helping reduce the attrition of a sample of Air Force trainees at risk for discharge from basic military training . Participants were 178 trainees referred for a psychological evaluation from basic training . Participants were r and omly assigned to a 2-session stress management group or a usual-care control condition . Compared with past studies that used less rigorous methodology , this study did not find that exposure to stress management information increased the probability of graduating basic military training . Results are discussed in terms of possible reasons for the lack of treatment effects and directions for future research Stress is a costly and significant source of health problems and mental distress -- with work cited as a primary stressor . This pilot study supports the effectiveness of a new workplace stress intervention : Chicken Soup for the Soul at Work Employee Groups . In this program , employee- participants met during nine weekly meetings to read inspirational workplace stories , comment , and share their own stories . A leader , chosen from and by the group , guided meetings . Utilizing a wait-list control group design , participants were r and omly assigned to an experimental or wait-list group . Participants completed pretests and posttests ( Coping Re sources Inventory , Occupational Stress Inventory-Revised , Job Descriptive Index , Pressure Management Indicator , survey ) . Statistical interaction effect for subtests was evaluated using a two-way repeated measures analysis of variance . Participants exhibited improved total coping re sources , cognitive/rational coping , state of mind , confidence and home/work balance . Participant comments and their continued participation in a similar company-sponsored program bolster these empirical results The purpose of the study was to examine the effectiveness of assertiveness training in improving self-perceived levels of stress and assertiveness among nurses in Taiwan , Republic of China . The two-group experimental design was conducted in a 2,000-bed veteran general hospital . A sample of 60 volunteer Chinese-speaking nurses participated in the study . Subjects were r and omly assigned to one of two treatments : assertiveness training ( AT ) or alternate treatment control ( ATC ) , which served as a control and contained up date d knowledge of new computer technology for in patient setting s. Subjects in each group participated in six 2-hour workshops in the same two-week period . All subjects were pre- , post- , and follow-up posttested for stress and assertiveness with the Perceived Stress Scale ( PSS ) and Rathus Assertiveness Schedule ( RAS ) , respectively . Results revealed the following : ( 1 ) subjects in both groups of pretest were clearly subassertive and under considerable stress ; ( 2 ) by the end of training , the AT group scored significantly higher on the rating of assertiveness than those in the ATC group , and had successfully maintained their improvement by the 4-week follow-up ; and ( 3 ) by the end of training , the AT group reported significantly lower levels of stress than the ATC group as indicated on the PSS , and successfully maintained their improvements at the 4-week follow-up . Overall , the results indicate clear support for the effectiveness of assertiveness training for treating subassertive behaviors and stress in a population of professional nurses in Taiwan This study sought to develop a stress management program based on the arousal-attribution stress model and to evaluate the effectiveness of the program in reducing anxiety and depression experienced by nursing students . Forty-two sophomore and 34 senior nursing students in a private , sectarian , liberal arts college were r and omly assigned to experimental and control groups . All subjects were given pre- and posttests consisting of the State form of the State-Trait Anxiety Inventory and the Institute for Personality and Ability Testing Depression Scale . Posttest analysis indicated that the experimental group had significantly lower anxiety and depression than the control group ( p less than .05 ) . These results support the use of the arousal-attribution stress model as a theoretical framework for stress management training Our objective was to evaluate the effect of 12 weeks of stress management training ( SMT ) , physical exercise ( PE ) and an integrated health programme ( IHP ) in a worksite setting on subjective health complaints . To do this , we r and omly split 860 employees into the following groups : control ( n = 344 ) , PE ( n = 189 ) , IHP ( comprising physical exercise and health information ) ( n = 165 ) and SMT ( n = 162 ) . There were no significant effects on subjective health complaints , sick leave or job stress . However , strong and specific positive effects were experienced for the particular goal areas defined for each intervention . The PE group showed improved general health , physical fitness and muscle pain , while the SMT group showed improved stress management . The IHP group showed the strongest effects , affecting most goals set for treatment In this study the effects of a worksite stress management intervention on changes in coping styles were examined . Ninety-five participants were r and omly assigned to an experimental group participating in the intervention or to a control group with a delayed intervention . The stress management intervention was structured on enhancing so-called positive coping styles focused on problem solving and social diversion and on decreasing  negative — emotion-focused  and  distraction — coping . The results showed that in the experimental group the level of positive coping styles significantly increased . The effect of decreased negative coping styles due to the intervention was observed only in the group of participants with a high level of negative affectivity This article describes a comparative stress 
    Output:
    
The incomplete reporting of information relevant to process evaluation makes it difficult to identify reliable determinants of effective intervention implementation or outcomes