human
***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: Background Distress and burnout among medical and psychology professionals are commonly reported and have implication s for the quality of patient care delivered . Already in the course of university studies , medicine and psychology students report mental distress and low life satisfaction . There is a need for interventions that promote better coping skills in students in order to prevent distress and future burnout . This study examines the effect of a seven-week Mindfulness-Based Stress Reduction ( MBSR ) programme on mental distress , study stress , burnout , subjective well-being , and mindfulness of medical and psychology students . Methods A total of 288 students ( mean age = 23 years , 76 % female ) from the University of Oslo and the University of Tromsø were r and omly allocated to an intervention or control group . The control group continued with their st and ard university courses and received no intervention . Participants were evaluated using self-reported measures both before and after the intervention . These were : the ‘ General Health Question naire , Maslach Burnout Inventory Student version , Perceived Medical School Stress , Subjective Well-being , and Five Facet Mindfulness Question naire ’ and additional indices of compliance . Results Following the intervention , a moderate effect on mental distress ( Hedges’g 0.65 , CI = .41 , .88 ) , and a small effect on both subjective well-being ( Hedges’g 0.40 , CI = .27 , .63 ) and the mindfulness facet ‘ non-reacting ’ ( Hedges’g 0.33 , CI = .10 , .56 ) were found in the intervention group compared with the control group . A higher level of programme attendance and reported mindfulness exercises predicted these changes . Significant effects were only found for female students who additionally reported reduced study stress and an increase in the mindfulness facet ‘ non-judging ’ . Gender specific effects of participation in the MBSR programme have not previously been reported , and gender differences in the present study are discussed . Conclusion Female medical and psychology students experienced significant positive improvements in mental distress , study stress , subjective well-being and mindfulness after participating in the MBSR programme . Trial registration In a prospect i ve r and omised controlled trial , 48 students were r and omly assigned to stress reduction training before exams with self-hypnosis , Johrei or a mock neurofeedback relaxation control .  Peripheral blood lymphocyte sub population s and self-reported stress ( Perceived Stress Scale ) were measured before training and 1 - 2 months later as exams approached . Absolute number and percentages of CD3(+)CD4(+ ) and CD3(+)CD8(+ ) T lymphocytes , CD3(-)CD56(+ ) Natural Killer cells ( NK cells ) and NK cell cytotoxic activity was measured from venous blood . Stressed participants showed small but significant declines in both CD3(-)CD56(+ ) NK cell percentages and NK cell cytotoxic activity levels while CD3(+)CD4(+ ) T cell percentages increased , changes supported by correlations with perceived stress . The effects of stress were moderated in those who learned Johrei at exam time ; 11/12 showed increases in CD3(-)CD56(+ ) NK cell percentages with decreased percentages of CD3(+)CD4(+ ) T cells , effects not seen in the relaxation control group . Stress was also buffered in those who learned and practised self-hypnosis in whom CD3(-)CD56(+ ) NK cell and CD3(+)CD4(+ ) T cell levels were maintained , and whose CD3(+)CD8(+ ) T cell percentages , shown previously to decline with exams , increased . The results compliment beneficial effects on mood of self-hypnosis and Johrei . The results are in keeping with beneficial influences of self-hypnosis and provide the first evidence of the suggestive value of the Japanese Johrei procedure for stress reduction , which clearly warrants further investigation Abstract This study ( N = 35 ) used a r and omized control design , and participants were collected from a variety of groups . After evaluating their degree of stress and burnout , coping styles , general well-being , and hypnotizability  , participants were matched by stress level and r and omly assigned to an intervention or wait-list group . The intervention comprised an audio recording of a hypnotic induction accompanied by suggestions for progressive relaxation , imagery , and anchoring to be used for 2 weeks . The results show that , as compared with baseline and wait-list conditions , the hypnotic intervention had a medium-to-large beneficial effect on participants ’ experience of stress , burnout , and well-being . Some participants also decreased their use of the coping strategy escape-avoidance postintervention . Hypnotizability correlated significantly or marginally with some outcomes of the intervention , but only for 1 group 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 AIM The aim of this investigation was to measure the impact of a self-administered hypnosis intervention on resilience and the inflammatory cytokine IL-6 . METHOD Over a period of 12 weeks , 11 participants listened to a self-administered hypnosis stress reduction program design ed to recondition and improve participants ' emotional and physical reactions to perceived work and life stressors . Subjects were administered subjective measures of coping , resilience , and stress tolerance , as well as , IL-6 , an objective blood measure of inflammatory activity . RESULTS After 12 weeks , participants were observed to have a significantly lower IL-6 serum level from baseline . Further , participants reported a significant decrease in the use of negative appraisal coping ( such as , self-deprecating statements , perfectionism , and catastrophic and pessimistic thinking ) , and an improvement in eating/nutritional habits following the intervention . Baseline eating/nutritional habits and threat minimization coping significantly predicted a change in serum IL-6 over the course of the intervention in stepwise hierarchical regression analyses . CONCLUSION Pilot study provides support that a brief self-administered CD hypnosis stress reduction program can modify a physiological measure of inflammation ( IL-6 ) , and improve coping and resilience in the face of work and life stress Background Chronic stress affects many Americans . Stress management programs may be prohibitively expensive or have limited access . Purpose This study aims to determine feasibility of an 8-week Internet-based stress management program ( ISM ) based on mindfulness principles in reducing stress in a 12-week , parallel , r and omized , controlled trial . Methods Participants were r and omly allocated to ISM , ISM plus online message board ( ISM+ ) , or control groups .  Perceived stress , mindfulness , self-transcendence , psychological well-being , vitality , and quality of life were measured at baseline , week 8 , and week 12 using st and ard vali date d question naires . Results ISM and ISM+ groups demonstrated statistically significant improvements compared with control on all measures except vitality and physical health . Conclusions The ISM program effectively and sustainably reduced measures of stress . The magnitude of improvement is comparable to traditional mindfulness programs , although fewer participants were engaged . This feasibility study provides strong support for online stress management programs , which increase access at a fraction of cost of traditional programs The effects of self-hypnosis training on immune function and mood were examined in medical students at exam time . Hypnosis involved relaxation and imagery directed at improved immune function and increased energy , alertness and concentration . Hypotheses were made about activated and withdrawn personality differences . Eight high and eight low hypnotically susceptible participants were given 10 sessions of hypnosis  , one live and nine tape-recorded , and were compared with control subjects ( N=12 ) .  CD3 , CD4 , CD8 , CD19 and CD56 NK cells and blood cortisol were assayed . Life-style , activated vs. withdrawn temperament , arousal and anxiety question naires were administered . Self-hypnosis buffered the decline found in controls in NK ( P<0.002 ) and CD8 cells ( P<0.0.07 ) and CD8/CD4 % ( P<0.06 ) ( 45 - 35 % order of magnitude differences ) while there was an increase in cortisol ( P<0.05 ) . The change in NK cell counts correlated positively with changes in both CD8 cells and cortisol . Results were independent of changes in life-style . Energy ratings were higher after hypnosis ( P<0.01 ) , and increased calmness with hypnosis correlated with an increase in CD4 counts ( P<0.01 ) . The activated temperament , notably the cognitive subscale ( speaking and thinking quickly ) , was predictive of exam levels of T and B lymphocytes ( P&z . Lt;0.08-P<0.02 ) , and reaching r=0.72 ( P<0.001 ) in the non-intervention control group . The sizeable influences on cell-mediated immunity achieved by a relatively brief , low cost psychological intervention in the face of a compelling , but routine , stress in young , healthy adults have implication s for illness prevention and for patients with compromised immunity This study assessed the psychosocial modulation of cellular immunity in 34 medical-student volunteers . The first blood sample was obtained 1 month before examinations , and the second on the day of examinations . There were significant declines in the percentage of helper/inducer T- lymphocytes , in the helper/inducer-suppressor/cytotoxic-cell ratio , and in natural killer-cell activity in the blood sample s obtained on the day of examinations . Half of the subjects were r and omly assigned to a relaxation group which met between sample points ; the frequency of relaxation practice was a significant predictor of the percentages of helper/inducer cells in the examination sample . Three biochemical nutritional assays ( albumin , transferrin , and total iron-binding protein ) were within normal limits on both sample s. Data from the Brief Symptom Inventory showed significantly increased global self-rated distress associated with examinations in the no-intervention group , compared to nonsignificant change in the relaxation group . Clinical and theoretical implication s are discussed It has been suggested that teacher stress might be reduced through cognitive restructuring which is aim ed at improving the rationality of their thinking . To test this hypothesis , 40 high school teachers were paired on their level of reasonable thinking , operationalized in terms of scores on the Teacher Idea Inventory ( Bernard , Joyce , & Rosewarne , 1983 ) , and allocated at r and om to one of 2 groups . They also completed the Face Valid Stress Test . The experimental group participated in 4 weekly treatment sessions involving a hypnotic induction and suggestions derived from key elements of Rational-Emotive Therapy . These focused on the reduction of what Ellis ( Ellis & Grieger , 1977 ) , the originator of this treatment , calls " irrational thinking . " The control group spent the same amount of time discussing stress reduction methods . Both the  Face Valid Stress Test and the Teacher Idea Inventory  were re-administered at the end of this period and again 12 months after conclusion of the experiment . Results indicated that both the experimental and control groups significantly reduced their levels of irrational thinking and stress , although the former 's improvement was more marked , particularly at the 12-month follow-up Post-ischaemic flow mediated dilation of peripheral arteries ( FMD ) is transiently reduced during mental stress . This experiment was aim ed at assessing whether hypnosis , which is a powerful relaxation technique , modulated the FMD response to mental stress in subjects with different hypnotic susceptibility . Results showed that hypnotic relaxation prevented the expected stress-related reduction of FMD only in highly hypnotizable subjects , suggesting a protective role of hypnotisability against vascular damage This study implemented an innovative new model of delivering a Mindfulness-Based Stress Reduction ( MBSR ) program that replaces six of the eight traditional in-person sessions with group telephonic sessions ( tMBSR ) and measured the program 's impact on the health and well-being of nurses employed within a large health care organization . As part of a nonr and omized pre – post intervention study , 36 nurses completed measures of health , stress , burnout , self-compassion , serenity , and empathy at three points in time . Between baseline ( Time 1 ) and the end of the 8-week tMBSR intervention ( Time 2 ) , participants showed improvement in general health , t(37 ) = 2.8 , p < .01 , decreased stress , t(37 ) = 6.8 , p < .001 , decreased work burnout , t(37 ) = 4.0 , p < .001 , and improvement in several other areas . Improvements were sustained 4 months later ( Time 3 ) , and individuals who continued their MBSR practice after the program demonstrated better outcomes than those that did not . Findings suggest that the tMBSR program can be a low cost , feasible , and scalable intervention that shows positive impact on health and well-being , and could allow MBSR to be delivered to employees who are otherwise unable to access traditional , on-site programs To assess the influence of a hypnotic intervention on cellular immune function during a commonplace stressful event , the authors selected 33 medical and dental students on the basis of hypnotic susceptibility . Initial blood sample s were obtained during a lower stress period , and a second sample was drawn 3 days before the first major exam of the term . Half of the participants were r and omly assigned to hypnotic-relaxation training in the interval between sample s. Participants in the hypnotic group were , on average , protected from the stress-related decrements that were observed in control participants ' proliferative responses to 2 mitogens , percentages of CD3 + and CD4 + T-lymphocytes , and interleukin 1 production by peripheral blood leukocytes . More frequent hypnotic-relaxation practice was associated with higher percentages of CD3 + and CD4 + T-lymphocytes . These data provide encouraging evidence that interventions may reduce the immunological dysregulation associated with acute stressors & NA 
    Output:
    
agent
Conclusions Due to exploratory design s and high risk of bias , the effectiveness of hypnosis or hypnotherapy in stress reduction remains still unclear .
***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: Background Distress and burnout among medical and psychology professionals are commonly reported and have implication s for the quality of patient care delivered . Already in the course of university studies , medicine and psychology students report mental distress and low life satisfaction . There is a need for interventions that promote better coping skills in students in order to prevent distress and future burnout . This study examines the effect of a seven-week Mindfulness-Based Stress Reduction ( MBSR ) programme on mental distress , study stress , burnout , subjective well-being , and mindfulness of medical and psychology students . Methods A total of 288 students ( mean age = 23 years , 76 % female ) from the University of Oslo and the University of Tromsø were r and omly allocated to an intervention or control group . The control group continued with their st and ard university courses and received no intervention . Participants were evaluated using self-reported measures both before and after the intervention . These were : the ‘ General Health Question naire , Maslach Burnout Inventory Student version , Perceived Medical School Stress , Subjective Well-being , and Five Facet Mindfulness Question naire ’ and additional indices of compliance . Results Following the intervention , a moderate effect on mental distress ( Hedges’g 0.65 , CI = .41 , .88 ) , and a small effect on both subjective well-being ( Hedges’g 0.40 , CI = .27 , .63 ) and the mindfulness facet ‘ non-reacting ’ ( Hedges’g 0.33 , CI = .10 , .56 ) were found in the intervention group compared with the control group . A higher level of programme attendance and reported mindfulness exercises predicted these changes . Significant effects were only found for female students who additionally reported reduced study stress and an increase in the mindfulness facet ‘ non-judging ’ . Gender specific effects of participation in the MBSR programme have not previously been reported , and gender differences in the present study are discussed . Conclusion Female medical and psychology students experienced significant positive improvements in mental distress , study stress , subjective well-being and mindfulness after participating in the MBSR programme . Trial registration In a prospect i ve r and omised controlled trial , 48 students were r and omly assigned to stress reduction training before exams with self-hypnosis , Johrei or a mock neurofeedback relaxation control .  Peripheral blood lymphocyte sub population s and self-reported stress ( Perceived Stress Scale ) were measured before training and 1 - 2 months later as exams approached . Absolute number and percentages of CD3(+)CD4(+ ) and CD3(+)CD8(+ ) T lymphocytes , CD3(-)CD56(+ ) Natural Killer cells ( NK cells ) and NK cell cytotoxic activity was measured from venous blood . Stressed participants showed small but significant declines in both CD3(-)CD56(+ ) NK cell percentages and NK cell cytotoxic activity levels while CD3(+)CD4(+ ) T cell percentages increased , changes supported by correlations with perceived stress . The effects of stress were moderated in those who learned Johrei at exam time ; 11/12 showed increases in CD3(-)CD56(+ ) NK cell percentages with decreased percentages of CD3(+)CD4(+ ) T cells , effects not seen in the relaxation control group . Stress was also buffered in those who learned and practised self-hypnosis in whom CD3(-)CD56(+ ) NK cell and CD3(+)CD4(+ ) T cell levels were maintained , and whose CD3(+)CD8(+ ) T cell percentages , shown previously to decline with exams , increased . The results compliment beneficial effects on mood of self-hypnosis and Johrei . The results are in keeping with beneficial influences of self-hypnosis and provide the first evidence of the suggestive value of the Japanese Johrei procedure for stress reduction , which clearly warrants further investigation Abstract This study ( N = 35 ) used a r and omized control design , and participants were collected from a variety of groups . After evaluating their degree of stress and burnout , coping styles , general well-being , and hypnotizability  , participants were matched by stress level and r and omly assigned to an intervention or wait-list group . The intervention comprised an audio recording of a hypnotic induction accompanied by suggestions for progressive relaxation , imagery , and anchoring to be used for 2 weeks . The results show that , as compared with baseline and wait-list conditions , the hypnotic intervention had a medium-to-large beneficial effect on participants ’ experience of stress , burnout , and well-being . Some participants also decreased their use of the coping strategy escape-avoidance postintervention . Hypnotizability correlated significantly or marginally with some outcomes of the intervention , but only for 1 group 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 AIM The aim of this investigation was to measure the impact of a self-administered hypnosis intervention on resilience and the inflammatory cytokine IL-6 . METHOD Over a period of 12 weeks , 11 participants listened to a self-administered hypnosis stress reduction program design ed to recondition and improve participants ' emotional and physical reactions to perceived work and life stressors . Subjects were administered subjective measures of coping , resilience , and stress tolerance , as well as , IL-6 , an objective blood measure of inflammatory activity . RESULTS After 12 weeks , participants were observed to have a significantly lower IL-6 serum level from baseline . Further , participants reported a significant decrease in the use of negative appraisal coping ( such as , self-deprecating statements , perfectionism , and catastrophic and pessimistic thinking ) , and an improvement in eating/nutritional habits following the intervention . Baseline eating/nutritional habits and threat minimization coping significantly predicted a change in serum IL-6 over the course of the intervention in stepwise hierarchical regression analyses . CONCLUSION Pilot study provides support that a brief self-administered CD hypnosis stress reduction program can modify a physiological measure of inflammation ( IL-6 ) , and improve coping and resilience in the face of work and life stress Background Chronic stress affects many Americans . Stress management programs may be prohibitively expensive or have limited access . Purpose This study aims to determine feasibility of an 8-week Internet-based stress management program ( ISM ) based on mindfulness principles in reducing stress in a 12-week , parallel , r and omized , controlled trial . Methods Participants were r and omly allocated to ISM , ISM plus online message board ( ISM+ ) , or control groups .  Perceived stress , mindfulness , self-transcendence , psychological well-being , vitality , and quality of life were measured at baseline , week 8 , and week 12 using st and ard vali date d question naires . Results ISM and ISM+ groups demonstrated statistically significant improvements compared with control on all measures except vitality and physical health . Conclusions The ISM program effectively and sustainably reduced measures of stress . The magnitude of improvement is comparable to traditional mindfulness programs , although fewer participants were engaged . This feasibility study provides strong support for online stress management programs , which increase access at a fraction of cost of traditional programs The effects of self-hypnosis training on immune function and mood were examined in medical students at exam time . Hypnosis involved relaxation and imagery directed at improved immune function and increased energy , alertness and concentration . Hypotheses were made about activated and withdrawn personality differences . Eight high and eight low hypnotically susceptible participants were given 10 sessions of hypnosis  , one live and nine tape-recorded , and were compared with control subjects ( N=12 ) .  CD3 , CD4 , CD8 , CD19 and CD56 NK cells and blood cortisol were assayed . Life-style , activated vs. withdrawn temperament , arousal and anxiety question naires were administered . Self-hypnosis buffered the decline found in controls in NK ( P<0.002 ) and CD8 cells ( P<0.0.07 ) and CD8/CD4 % ( P<0.06 ) ( 45 - 35 % order of magnitude differences ) while there was an increase in cortisol ( P<0.05 ) . The change in NK cell counts correlated positively with changes in both CD8 cells and cortisol . Results were independent of changes in life-style . Energy ratings were higher after hypnosis ( P<0.01 ) , and increased calmness with hypnosis correlated with an increase in CD4 counts ( P<0.01 ) . The activated temperament , notably the cognitive subscale ( speaking and thinking quickly ) , was predictive of exam levels of T and B lymphocytes ( P&z . Lt;0.08-P<0.02 ) , and reaching r=0.72 ( P<0.001 ) in the non-intervention control group . The sizeable influences on cell-mediated immunity achieved by a relatively brief , low cost psychological intervention in the face of a compelling , but routine , stress in young , healthy adults have implication s for illness prevention and for patients with compromised immunity This study assessed the psychosocial modulation of cellular immunity in 34 medical-student volunteers . The first blood sample was obtained 1 month before examinations , and the second on the day of examinations . There were significant declines in the percentage of helper/inducer T- lymphocytes , in the helper/inducer-suppressor/cytotoxic-cell ratio , and in natural killer-cell activity in the blood sample s obtained on the day of examinations . Half of the subjects were r and omly assigned to a relaxation group which met between sample points ; the frequency of relaxation practice was a significant predictor of the percentages of helper/inducer cells in the examination sample . Three biochemical nutritional assays ( albumin , transferrin , and total iron-binding protein ) were within normal limits on both sample s. Data from the Brief Symptom Inventory showed significantly increased global self-rated distress associated with examinations in the no-intervention group , compared to nonsignificant change in the relaxation group . Clinical and theoretical implication s are discussed It has been suggested that teacher stress might be reduced through cognitive restructuring which is aim ed at improving the rationality of their thinking . To test this hypothesis , 40 high school teachers were paired on their level of reasonable thinking , operationalized in terms of scores on the Teacher Idea Inventory ( Bernard , Joyce , & Rosewarne , 1983 ) , and allocated at r and om to one of 2 groups . They also completed the Face Valid Stress Test . The experimental group participated in 4 weekly treatment sessions involving a hypnotic induction and suggestions derived from key elements of Rational-Emotive Therapy . These focused on the reduction of what Ellis ( Ellis & Grieger , 1977 ) , the originator of this treatment , calls " irrational thinking . " The control group spent the same amount of time discussing stress reduction methods . Both the  Face Valid Stress Test and the Teacher Idea Inventory  were re-administered at the end of this period and again 12 months after conclusion of the experiment . Results indicated that both the experimental and control groups significantly reduced their levels of irrational thinking and stress , although the former 's improvement was more marked , particularly at the 12-month follow-up Post-ischaemic flow mediated dilation of peripheral arteries ( FMD ) is transiently reduced during mental stress . This experiment was aim ed at assessing whether hypnosis , which is a powerful relaxation technique , modulated the FMD response to mental stress in subjects with different hypnotic susceptibility . Results showed that hypnotic relaxation prevented the expected stress-related reduction of FMD only in highly hypnotizable subjects , suggesting a protective role of hypnotisability against vascular damage This study implemented an innovative new model of delivering a Mindfulness-Based Stress Reduction ( MBSR ) program that replaces six of the eight traditional in-person sessions with group telephonic sessions ( tMBSR ) and measured the program 's impact on the health and well-being of nurses employed within a large health care organization . As part of a nonr and omized pre – post intervention study , 36 nurses completed measures of health , stress , burnout , self-compassion , serenity , and empathy at three points in time . Between baseline ( Time 1 ) and the end of the 8-week tMBSR intervention ( Time 2 ) , participants showed improvement in general health , t(37 ) = 2.8 , p < .01 , decreased stress , t(37 ) = 6.8 , p < .001 , decreased work burnout , t(37 ) = 4.0 , p < .001 , and improvement in several other areas . Improvements were sustained 4 months later ( Time 3 ) , and individuals who continued their MBSR practice after the program demonstrated better outcomes than those that did not . Findings suggest that the tMBSR program can be a low cost , feasible , and scalable intervention that shows positive impact on health and well-being , and could allow MBSR to be delivered to employees who are otherwise unable to access traditional , on-site programs To assess the influence of a hypnotic intervention on cellular immune function during a commonplace stressful event , the authors selected 33 medical and dental students on the basis of hypnotic susceptibility . Initial blood sample s were obtained during a lower stress period , and a second sample was drawn 3 days before the first major exam of the term . Half of the participants were r and omly assigned to hypnotic-relaxation training in the interval between sample s. Participants in the hypnotic group were , on average , protected from the stress-related decrements that were observed in control participants ' proliferative responses to 2 mitogens , percentages of CD3 + and CD4 + T-lymphocytes , and interleukin 1 production by peripheral blood leukocytes . More frequent hypnotic-relaxation practice was associated with higher percentages of CD3 + and CD4 + T-lymphocytes . These data provide encouraging evidence that interventions may reduce the immunological dysregulation associated with acute stressors & NA 
    Output:
    