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: A series of UK and European audits have revealed that a high proportion of patients remain dissatisfied with the information they received following a diagnosis of cancer . Additional educational aids are often required to facilitate the consent process , and our previous work showed a high level of acceptability for video-directed information for this purpose . In this study a multidisciplinary team of health professionals worked with patients , a documentary film company and experienced television personalities to produce an information film . The aim of this study was to assess the benefits of receiving a cassette to take home following the first consultation and this was evaluated in a r and omised multicentre controlled study among 220 patients receiving chemotherapy or radiotherapy over a 6-month period . There was a significant correlation between satisfaction and reduced treatment-related anxiety overall . In the video group , the mean Hospital Anxiety and Depression ( HAD ) anxiety score was significantly lower during treatment compared with the non-video group ( 4.6+/-3.7 ( range : 0 - 18 ) versus 7.4+/-5.2 ( range : 0 - 20 ) , Chi square test P=0.001 ) . Likewise , the mean HAD depression scores were also significantly lower in the patients prepared for the side-effects of treatment with the video ( 2.9+/-2.9 ( range : 0 - 13 ) versus 5.3+/-4.7 ( range : 0 - 21 ) Chi square test P=0.001 ) . 81 % felt the video was helpful , only 5 % of patients felt this extra information was worrying . Well design ed video cassettes should be regarded as a useful additional information strategy , within routine oncology practice Importance Shared decision making helps patients and clinicians elect therapies aligned with patients ’ values and preferences . This is particularly important for invasive therapies with considerable trade-offs . Objective To assess the effectiveness of a shared decision support intervention for patients considering destination therapy left ventricular assist device ( DT LVAD ) placement . Design , Setting , and Participants From 2015 to 2017 , a r and omized , stepped-wedge trial was conducted in 6 US LVAD implanting centers including 248 patients being considered for DT LVAD . After r and omly varying time in usual care , sites were transitioned to an intervention consisting of clinician education and use of DT LVAD pamphlet and video patient decision aids . Follow up occurred at 1 and 6 months . Main Outcomes and Measures Decision quality as measured by knowledge and values-choice concordance . Results In total , 135 patients were enrolled during control and 113 during intervention periods . At enrollment , 59 ( 23.8 % ) participants were in intensive care , 60 ( 24.1 % ) were older than 70 years , 39 ( 15.7 % ) were women , 45 ( 18.1 % ) were racial/ethnic minorities , and 62 ( 25.0 % ) were college graduates  . Patient knowledge ( mean test performance ) during the decision-making period improved from 59.5 % to 64.9 % in the control group vs 59.1 % to 70.0 % in the intervention group ( adjusted difference of difference , 5.5 % ; P = .03 ) . Stated values at 1 month ( scale 1 = “ do everything I can to live longer … ” to 10 = “ live with whatever time I have left … ” ) were a mean of 2.37 in control and 3.33 in intervention ( P = .03 ) . Patient-reported treatment choice at 1 month favored LVAD more in the control group ( than in the intervention group ( 47 [ 59.5 % ] vs 95 [ 91.3 % ] , P < .001 ) . Correlation between stated values and patient-reported treatment choice at 1 month was stronger in the intervention group than in the control group ( difference in Kendall ’s & tgr ; , 0.28 ; 95 % CI , 0.05 - 0.45 ) ; however , there was no improved correlation between stated values and actual treatment received by 6 months for the intervention compared with the control group ( difference in Kendall ’s & tgr ; , 0.01 ; 95 % CI , −0.24 to 0.25 ) . The adjusted rate of LVAD implantation by 6 months was higher for those in the control group ( 79.9 % ) than those in the intervention group ( 53.9 % , P = .008 ) , with significant variation by site . There were no differences in decision conflict , decision regret , or preferred control . Conclusions and Relevance A shared decision-making intervention for DT LVAD modestly improved patient decision quality as measured by patient knowledge and concordance between stated values and patient-reported treatment choice , but did not improve concordance between stated values and actual treatment received . The rate of implantation of LVADs was substantially lower in the intervention compared with the control group . Trial Registration clinical trials.gov Identifier : ABSTRACT Objectives : Patients with inflammatory bowel diseases ( IBD ) have to deal with a poor quality of life ( QOL ) and psychomorbidity result ing from an incurable illness . We aim ed to study the effect of patient education on QOL , compliance , anxiety and depression in IBD . Methods : Patients were prospect ively enrolled over two years beginning July 2014 and divided into an interventional and usual care group . Both received the st and ard of care , but the former in addition received an 8 min session of video-assisted education . Compliance to drugs was defined as drug intake of > 80 % of the prescribed dose , and adherence to scheduled follow up visits were also compared . Self-administered question naires namely Short IBD question naire ( SIBDQ ) , Beck Anxiety and Depression Inventory ( BAI , BDI-II ) , Hospital Anxiety and Depression Scale ( HADS ) were used to assess QOL , anxiety and depression respectively at baseline , 6 months and 1 year . Results : Of the 91 patients enrolled , 84 [ 92.3 % ; male = 66 ( 78.57 % ) ] completed the follow up . Significantly more patients were compliant to follow up visits in the intervention and usual care groups respectively at 6 months ( 88.4 % versus 65.8 % respectively ; p < 0.01 ) and 1 year ( 72.1 % versus 46.3 % respectively ; p < 0.01 ) . The median ( IQR ) scores for HADS-Depression over 1 year were significantly better in the interventional group than usual care ( p < 0.049 ) . The differences in SIBDQ , BDI-II , BAI , HADS-Anxiety and compliance to drug therapy between the groups did not reach statistical significance . Conclusion : Video assisted patient education  improved compliance to follow up visits and depression scores in IBD . Further modifications in the educational video content and delivery might improve compliance to drug therapy , QOL and anxiety scores OBJECTIVE Adherence to self-care behaviors improves heart failure ( HF )  morbidity and life quality . We examined short-term impact of video education ( VE ) in addition to st and ard education ( SE ) on HF healthcare utilization and self-care behavior adherence . METHODS One hundred and twelve hospitalized patients were r and omly assigned to SE ( n=53 ) or SE plus VE ( n=59 ) . Differences between groups were analyzed in patients who underwent 3-month follow-up ( 39 SE and 37 VE patients ) . Mean age was 60+/-14 years ; mean HF length was 57 months . RESULTS Three-month healthcare utilization was similar between groups but VE patients needed less extra diuretic dosing ( P<0.02 ) , received more HF literature ( P<0.03 ) , and had less healthcare team telephone communication ( P<0.04 ) . VE patients had greater sign/symptom reduction ( P<0.04 ) ; especially related to edema ( P<0.01 ) and fatigue ( P<0.01 ) and initiated more actions for edema ( P<0.05 ) and dyspnea ( with exercise or rest , both P<0.01 ) . Overall , VE patients had a higher mean self-care behavior score ( P<0.01 ) , reflecting greater self-care adherence . CONCLUSION Video education prompts self-care behavior adherence to control worsening signs/symptoms of volume overload . During 3-month follow-up , utilization of most healthcare re sources was unchanged . PRACTICE IMPLICATION S VE is a useful adjunct to in-person education The authors r and omly assigned 5th- and 8th- grade students to 1 of 3 treatment conditions to study the effects of frequency of exposure to an antismoking public service announcement ( PSA ) on the students ' intent to smoke over time . They found that , among younger children only , viewing an antismoking PSA at least once reduced smoking intentions , although these positive effects did not remain over time . However , the antismoking PSA was effective for younger at-risk children . After younger at-risk children viewed the antismoking PSA once , their intent to smoke decreased significantly . Notably , these positive effects remained stable over time and mirrored the smoking intentions of younger children who were not identified as at risk High social anxiety is a risk factor for the incidence of social anxiety disorder ( SAD ) . Early diagnosis and intervention may prevent more severe psychiatric courses . Self-help programs may be a convenient , accessible , and effective intervention . This study examined the efficacy of a newly developed self-help program for SAD in individuals with subthreshold social anxiety . A total of 24 highly socially anxious individuals were r and omly assigned to a DVD-based self-help program or to a wait-list control group . The self-help program is based on the cognitive model according to Clark and Wells ( 1995 ; adapted to German by Stangier , Clark , & Ehlers , 2006 ) and comprises eight sessions . ANOVAs based on an intention-to-treat model were used for data analyses . The self-help program was well accepted ; just one person withdrew during the intervention . There were significant Time × Group interactions on all primary outcome measures . For the intervention group moderate to high within-groups effect sizes up to Cohen 's d = 1.05 were obtained . Between-groups effect sizes ranged from 0.24 to 0.65 in favor of the active intervention . The newly developed DVD-based self-help program seems to be a promising intervention for  highly socially anxious individuals as it reduces social anxiety symptoms Abstract Background Videotaped education material s to teach breast self-examination ( BSE ) are used worldwide . However , evaluation of videotaped BSE instructions is lacking . Methods Premenopausal women ( mean age 33.4 ± 11.2 years ) without history of breast cancer were approached to participate in this experimental study and r and omly assigned to a video intervention group ( VG ; n = 130 ; length of the video = 15 min ) or non-video comparison group ( NVG ; n = 121 ) . All participants answered a question naire on BSE behavior and health beliefs . No additional training was given . The total duration of the session including completion of the question naire was 15 min for the NVG and 30 min for the VG . Three months later , changes in BSE behavior were compared in the two groups . The influence of health beliefs on actual BSE behavior was investigated as well . Results Women of both the VG and NVG performed BSE significantly more frequently at follow-up than at baseline . Analysis of covariance , using the baseline BSE-frequency as co-variate and the follow-up BSE frequency as the dependent variable , revealed that women in the VG ( adjusted mean = 7.9 times per year , 95%CI = 6.5–9.4 ) performed BSE more frequently than women of the NVG ( adjusted mean = 6.1 times per year , 95%CI = 4.6–7.5 ) ( F = 4.2 , df = 2 , p = 0.02 ) . Among motivational predictors , having an example of a role model ( modeling ) was shown by regression analysis to explain the greatest amount of variance ( 13 % ) in BSE frequency . Conclusion Use of an educational videotape  increased the frequency of BSE among premenopausal women This study involved the initial development and testing of a video self-help intervention called LifeStories , which features real patients describing their use of coping strategies for depression based on Acceptance and Commitment Therapy . We conducted a baseline-controlled open trial ( AB design ) of 11 individuals diagnosed with major depressive disorder . Participants reported high levels of satisfaction and transportation ( i.e. , engagement ) after watching LifeStories . No significant changes were observed during the 4-week baseline period in terms of interviewer-rated depression severity ( primary outcome ) , but a significant and large effect size improvement was observed at Week 8 postintervention . The majority of participants ( 54.5 % ) showed a reliable and clinical ly significant posttreatment response . Significant improvements also were observed during the intervention period only for self-reported depressive symptoms and aspects of mindfulness ( nonreactivity ) . Qualitative data analysis of participant interviews identified additional areas for improvement and refinement . Future testing in a r and omized trial is warranted based on these encouraging results This study examines smoking cessation content posted on youtube.com . The search terms “ quit smoking ” and “ stop smoking ” yielded 2,250 videos in October 2007 . We examined the top 100 as well as 20 r and omly selected videos . Of these , 82 were directly relevant to smoking cessation . Fifty-one were commercial productions that included antismoking messages and advertisements for hypnosis and NicoBloc fluid . Thirty-one were personally produced videos that described personal experiences with quitting , negative health effects , and advice on how to quit . Although smoking cessation content is being shared on YouTube , very little is based on strategies that have been shown to be effective OBJECTIVE Compare effects of narrative and 
    Output:
    
agent
***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: A series of UK and European audits have revealed that a high proportion of patients remain dissatisfied with the information they received following a diagnosis of cancer . Additional educational aids are often required to facilitate the consent process , and our previous work showed a high level of acceptability for video-directed information for this purpose . In this study a multidisciplinary team of health professionals worked with patients , a documentary film company and experienced television personalities to produce an information film . The aim of this study was to assess the benefits of receiving a cassette to take home following the first consultation and this was evaluated in a r and omised multicentre controlled study among 220 patients receiving chemotherapy or radiotherapy over a 6-month period . There was a significant correlation between satisfaction and reduced treatment-related anxiety overall . In the video group , the mean Hospital Anxiety and Depression ( HAD ) anxiety score was significantly lower during treatment compared with the non-video group ( 4.6+/-3.7 ( range : 0 - 18 ) versus 7.4+/-5.2 ( range : 0 - 20 ) , Chi square test P=0.001 ) . Likewise , the mean HAD depression scores were also significantly lower in the patients prepared for the side-effects of treatment with the video ( 2.9+/-2.9 ( range : 0 - 13 ) versus 5.3+/-4.7 ( range : 0 - 21 ) Chi square test P=0.001 ) . 81 % felt the video was helpful , only 5 % of patients felt this extra information was worrying . Well design ed video cassettes should be regarded as a useful additional information strategy , within routine oncology practice Importance Shared decision making helps patients and clinicians elect therapies aligned with patients ’ values and preferences . This is particularly important for invasive therapies with considerable trade-offs . Objective To assess the effectiveness of a shared decision support intervention for patients considering destination therapy left ventricular assist device ( DT LVAD ) placement . Design , Setting , and Participants From 2015 to 2017 , a r and omized , stepped-wedge trial was conducted in 6 US LVAD implanting centers including 248 patients being considered for DT LVAD . After r and omly varying time in usual care , sites were transitioned to an intervention consisting of clinician education and use of DT LVAD pamphlet and video patient decision aids . Follow up occurred at 1 and 6 months . Main Outcomes and Measures Decision quality as measured by knowledge and values-choice concordance . Results In total , 135 patients were enrolled during control and 113 during intervention periods . At enrollment , 59 ( 23.8 % ) participants were in intensive care , 60 ( 24.1 % ) were older than 70 years , 39 ( 15.7 % ) were women , 45 ( 18.1 % ) were racial/ethnic minorities , and 62 ( 25.0 % ) were college graduates  . Patient knowledge ( mean test performance ) during the decision-making period improved from 59.5 % to 64.9 % in the control group vs 59.1 % to 70.0 % in the intervention group ( adjusted difference of difference , 5.5 % ; P = .03 ) . Stated values at 1 month ( scale 1 = “ do everything I can to live longer … ” to 10 = “ live with whatever time I have left … ” ) were a mean of 2.37 in control and 3.33 in intervention ( P = .03 ) . Patient-reported treatment choice at 1 month favored LVAD more in the control group ( than in the intervention group ( 47 [ 59.5 % ] vs 95 [ 91.3 % ] , P < .001 ) . Correlation between stated values and patient-reported treatment choice at 1 month was stronger in the intervention group than in the control group ( difference in Kendall ’s & tgr ; , 0.28 ; 95 % CI , 0.05 - 0.45 ) ; however , there was no improved correlation between stated values and actual treatment received by 6 months for the intervention compared with the control group ( difference in Kendall ’s & tgr ; , 0.01 ; 95 % CI , −0.24 to 0.25 ) . The adjusted rate of LVAD implantation by 6 months was higher for those in the control group ( 79.9 % ) than those in the intervention group ( 53.9 % , P = .008 ) , with significant variation by site . There were no differences in decision conflict , decision regret , or preferred control . Conclusions and Relevance A shared decision-making intervention for DT LVAD modestly improved patient decision quality as measured by patient knowledge and concordance between stated values and patient-reported treatment choice , but did not improve concordance between stated values and actual treatment received . The rate of implantation of LVADs was substantially lower in the intervention compared with the control group . Trial Registration clinical trials.gov Identifier : ABSTRACT Objectives : Patients with inflammatory bowel diseases ( IBD ) have to deal with a poor quality of life ( QOL ) and psychomorbidity result ing from an incurable illness . We aim ed to study the effect of patient education on QOL , compliance , anxiety and depression in IBD . Methods : Patients were prospect ively enrolled over two years beginning July 2014 and divided into an interventional and usual care group . Both received the st and ard of care , but the former in addition received an 8 min session of video-assisted education . Compliance to drugs was defined as drug intake of > 80 % of the prescribed dose , and adherence to scheduled follow up visits were also compared . Self-administered question naires namely Short IBD question naire ( SIBDQ ) , Beck Anxiety and Depression Inventory ( BAI , BDI-II ) , Hospital Anxiety and Depression Scale ( HADS ) were used to assess QOL , anxiety and depression respectively at baseline , 6 months and 1 year . Results : Of the 91 patients enrolled , 84 [ 92.3 % ; male = 66 ( 78.57 % ) ] completed the follow up . Significantly more patients were compliant to follow up visits in the intervention and usual care groups respectively at 6 months ( 88.4 % versus 65.8 % respectively ; p < 0.01 ) and 1 year ( 72.1 % versus 46.3 % respectively ; p < 0.01 ) . The median ( IQR ) scores for HADS-Depression over 1 year were significantly better in the interventional group than usual care ( p < 0.049 ) . The differences in SIBDQ , BDI-II , BAI , HADS-Anxiety and compliance to drug therapy between the groups did not reach statistical significance . Conclusion : Video assisted patient education  improved compliance to follow up visits and depression scores in IBD . Further modifications in the educational video content and delivery might improve compliance to drug therapy , QOL and anxiety scores OBJECTIVE Adherence to self-care behaviors improves heart failure ( HF )  morbidity and life quality . We examined short-term impact of video education ( VE ) in addition to st and ard education ( SE ) on HF healthcare utilization and self-care behavior adherence . METHODS One hundred and twelve hospitalized patients were r and omly assigned to SE ( n=53 ) or SE plus VE ( n=59 ) . Differences between groups were analyzed in patients who underwent 3-month follow-up ( 39 SE and 37 VE patients ) . Mean age was 60+/-14 years ; mean HF length was 57 months . RESULTS Three-month healthcare utilization was similar between groups but VE patients needed less extra diuretic dosing ( P<0.02 ) , received more HF literature ( P<0.03 ) , and had less healthcare team telephone communication ( P<0.04 ) . VE patients had greater sign/symptom reduction ( P<0.04 ) ; especially related to edema ( P<0.01 ) and fatigue ( P<0.01 ) and initiated more actions for edema ( P<0.05 ) and dyspnea ( with exercise or rest , both P<0.01 ) . Overall , VE patients had a higher mean self-care behavior score ( P<0.01 ) , reflecting greater self-care adherence . CONCLUSION Video education prompts self-care behavior adherence to control worsening signs/symptoms of volume overload . During 3-month follow-up , utilization of most healthcare re sources was unchanged . PRACTICE IMPLICATION S VE is a useful adjunct to in-person education The authors r and omly assigned 5th- and 8th- grade students to 1 of 3 treatment conditions to study the effects of frequency of exposure to an antismoking public service announcement ( PSA ) on the students ' intent to smoke over time . They found that , among younger children only , viewing an antismoking PSA at least once reduced smoking intentions , although these positive effects did not remain over time . However , the antismoking PSA was effective for younger at-risk children . After younger at-risk children viewed the antismoking PSA once , their intent to smoke decreased significantly . Notably , these positive effects remained stable over time and mirrored the smoking intentions of younger children who were not identified as at risk High social anxiety is a risk factor for the incidence of social anxiety disorder ( SAD ) . Early diagnosis and intervention may prevent more severe psychiatric courses . Self-help programs may be a convenient , accessible , and effective intervention . This study examined the efficacy of a newly developed self-help program for SAD in individuals with subthreshold social anxiety . A total of 24 highly socially anxious individuals were r and omly assigned to a DVD-based self-help program or to a wait-list control group . The self-help program is based on the cognitive model according to Clark and Wells ( 1995 ; adapted to German by Stangier , Clark , & Ehlers , 2006 ) and comprises eight sessions . ANOVAs based on an intention-to-treat model were used for data analyses . The self-help program was well accepted ; just one person withdrew during the intervention . There were significant Time × Group interactions on all primary outcome measures . For the intervention group moderate to high within-groups effect sizes up to Cohen 's d = 1.05 were obtained . Between-groups effect sizes ranged from 0.24 to 0.65 in favor of the active intervention . The newly developed DVD-based self-help program seems to be a promising intervention for  highly socially anxious individuals as it reduces social anxiety symptoms Abstract Background Videotaped education material s to teach breast self-examination ( BSE ) are used worldwide . However , evaluation of videotaped BSE instructions is lacking . Methods Premenopausal women ( mean age 33.4 ± 11.2 years ) without history of breast cancer were approached to participate in this experimental study and r and omly assigned to a video intervention group ( VG ; n = 130 ; length of the video = 15 min ) or non-video comparison group ( NVG ; n = 121 ) . All participants answered a question naire on BSE behavior and health beliefs . No additional training was given . The total duration of the session including completion of the question naire was 15 min for the NVG and 30 min for the VG . Three months later , changes in BSE behavior were compared in the two groups . The influence of health beliefs on actual BSE behavior was investigated as well . Results Women of both the VG and NVG performed BSE significantly more frequently at follow-up than at baseline . Analysis of covariance , using the baseline BSE-frequency as co-variate and the follow-up BSE frequency as the dependent variable , revealed that women in the VG ( adjusted mean = 7.9 times per year , 95%CI = 6.5–9.4 ) performed BSE more frequently than women of the NVG ( adjusted mean = 6.1 times per year , 95%CI = 4.6–7.5 ) ( F = 4.2 , df = 2 , p = 0.02 ) . Among motivational predictors , having an example of a role model ( modeling ) was shown by regression analysis to explain the greatest amount of variance ( 13 % ) in BSE frequency . Conclusion Use of an educational videotape  increased the frequency of BSE among premenopausal women This study involved the initial development and testing of a video self-help intervention called LifeStories , which features real patients describing their use of coping strategies for depression based on Acceptance and Commitment Therapy . We conducted a baseline-controlled open trial ( AB design ) of 11 individuals diagnosed with major depressive disorder . Participants reported high levels of satisfaction and transportation ( i.e. , engagement ) after watching LifeStories . No significant changes were observed during the 4-week baseline period in terms of interviewer-rated depression severity ( primary outcome ) , but a significant and large effect size improvement was observed at Week 8 postintervention . The majority of participants ( 54.5 % ) showed a reliable and clinical ly significant posttreatment response . Significant improvements also were observed during the intervention period only for self-reported depressive symptoms and aspects of mindfulness ( nonreactivity ) . Qualitative data analysis of participant interviews identified additional areas for improvement and refinement . Future testing in a r and omized trial is warranted based on these encouraging results This study examines smoking cessation content posted on youtube.com . The search terms “ quit smoking ” and “ stop smoking ” yielded 2,250 videos in October 2007 . We examined the top 100 as well as 20 r and omly selected videos . Of these , 82 were directly relevant to smoking cessation . Fifty-one were commercial productions that included antismoking messages and advertisements for hypnosis and NicoBloc fluid . Thirty-one were personally produced videos that described personal experiences with quitting , negative health effects , and advice on how to quit . Although smoking cessation content is being shared on YouTube , very little is based on strategies that have been shown to be effective OBJECTIVE Compare effects of narrative and 
    Output:
    