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: Women with breast cancer are one of the largest groups of cancer survivors . This research examined whether breast cancer has a long-term impact on quality of life ( QOL ) by comparing 5-year disease-free survivors to age-matched controls and by comparing women who sustained a recurrence to disease-free survivors . Controls  were recruited using the neighborhood control methodology .  QOL ( physical , emotional , social , and spiritual ) was assessed during in-person interviews . There were no differences between disease-free survivors ( n = 267 ) and controls ( n = 187 ) on many indicators of QOL . However , survivors reported more difficulties with physical functioning , more physical symptoms , and more faith than did controls ( all ps < 0.05 ) . Compared to disease-free survivors , survivors with a recurrence ( n = 37 ) had a worse QOL on most indices , less positive affect , more general fatigue , and more intrusive and avoidant thoughts ( all ps < 0.05 ) . There were no differences between the two groups of survivors on indices of marriage , work experiences , or spirituality . These findings suggest that the QOL of long-term survivors who remain disease-free is comparable to that of women their age with the exception of physical functioning . Women who sustain a recurrence suffer an impaired QOL in some , but not all , domains AIM This paper is a report of a study to describe the efficacy of cognitive behavioural therapy for insomnia on fatigue , mood and quality of life in breast cancer survivors . BACKGROUND Women who receive primary treatment for breast cancer often complain of insomnia . Rarely evaluated in insomnia intervention studies is the effect of cognitive behavioural treatment on the psychosocial outcomes of fatigue , mood and quality of life . METHOD Data were collected between December 2002 and March 2004 with 72 women who were at least 3 months post-completion of primary treatment without current evidence of disease . Women were r and omly assigned to either the cognitive behavioural therapy for insomnia group , which received stimulus control instructions , sleep restriction therapy and sleep education and hygiene , or the component control group which received sleep education and hygiene only . The 10-week study consisted of 2 weeks of pre-treatment , 6 weeks of treatment and 2 weeks of post-treatment . Fatigue , mood and quality of life were measured at pre- and post-treatment . FINDINGS Women receiving cognitive behavioural therapy for insomnia had significant improvements in fatigue , trait anxiety , depression and quality of life . The component control group also had statistically significant increases in quality of life , with a trend suggestive of lower depression at post-treatment . CONCLUSION Globally , as the number of survivors in this population continues to grow , it is imperative that nurses continue testing interventions that may positively affect quality of life and the commonly experienced symptoms of fatigue , anxiety and depression The  long‐term impact of breast carcinoma and its treatment was assessed in 153 breast carcinoma survivors previously treated on a Phase III r and omized trial ( Cancer and Leukemia Group B [ CALGB 7581 ] ) a median of 20 years after entry to CALGB 7581 The European Organisation for Research and Treatment of Cancer ( EORTC ) quality of life question naire QLQ-C30 has been developed as a quantitative measure of health-related quality of life for use in clinical trials of cancer patients . Validity is an important measurement property of all scientific tests . This study contributes to the iterative process of validating the question naire by focusing on the psychosocial subscales of the QLQ-C30 , using baseline data from 150 patients participating in a r and omised trial of supportive group therapy for metastatic breast cancer . The results provide strong support for the discriminative validity of the global health/ quality of life , role function and social function subscales of the  QLQ-C30  , in patients differing according to clinical criteria . The psychosocial focus of the trial enabled expansion of criteria used to form patient subgroups , beyond medical factors , and consequently support was demonstrated for the discriminative validity of the emotional and cognitive function subscales . The degree of support for these subscales was less substantial than for the other QLQ-C30 subscales as there were fewer relevant criteria . Convergence assessed by correlations with independent measures of psychosocial function provides strong support for the convergent validity of the emotional function , role function and global health/ quality of life subscales of the QLQ-C30 , and moderate support for the social function subscales . There was little opportunity for the cognitive function subscale to associate with conceptually analogous subscales . Further testing is recommended with more comprehensive and specific measures of cognitive status . In general , the psychosocial subscales of the QLQ-C30 appear to be measuring the concepts they are purported to measure The aim of this study was to evaluate the impact of a twice-weekly strength training intervention on perceptions of body image in 234 breast cancer survivors ( 112 with lymphedema ) who participated in the Physical Activity and Lymphedema ( PAL ) trial . The study population included two hundred and thirty-four women r and omly assigned to twice-weekly strength training or control group that completed the 32-item Body Image and Relationships Scale ( BIRS ) at baseline and 12 months . Percent change in baseline to 12-month BIRS total and subscale scores , upper and lower body strength , and general quality of life ( QOL ) were compared by intervention status . A series of multiple linear regression models including indicator variables for subgroups based on age , marital status , race , education , BMI , and strength change were used to examine differential intervention impact by subgroup . Strength and QOL variables were assessed as mediators of the intervention effect on BIRS . Results : Baseline BIRS scores were similar across intervention and lymphedema status . Significantly greater improvement in BIRS total score was observed from baseline to 12 months in treatment vs. control participants ( 12.0 vs. 2.0 % ; P < 0.0001 ) . A differential impact of the intervention on the Strength and Health subscale was observed for older women ( > 50 years old ) in the treatment group ( P = 0.03 ) . Significantly greater improvement was observed in bench and leg press among treatment group when compared to control group participants , regardless of lymphedema . Observed intervention effects were independent of observed strength and QOL changes . Twice-weekly strength training positively impacted self-perceptions of appearance , health , physical strength , sexuality , relationships , and social functioning . Evidence suggests the intervention was beneficial regardless of prior diagnosis of lymphedema . Strength and QOL improvements did not mediate the observed intervention effects PURPOSE The purpose of the study was to determine the relationship between life-stage variables ( ie , age at diagnosis and years of survival ) and quality -of-life ( QOL ) outcomes in long-term survivors of breast cancer . DESCRIPTION OF STUDY In this cross-sectional study , 105 long-term survivors of breast cancer participated in a mailed survey assessing QOL .  Participants were selected from a cancer center tumor registry using a stratified r and om-sampling procedure that was based on age at diagnosis . The  Quality of Life-Cancer Survivors scale was used to assess QOL outcomes in the physical , psychological , social , and spiritual domains . RESULTS Long-term survivors of breast cancer who had received diagnoses at an older age ( > 65 years ) showed significantly ( P < .05 ) worse QOL outcomes in the physical domain , while those who had received diagnoses at a younger age ( 27 - 44 years ) showed worse QOL outcomes in the social domain than other age groups . A nonlinear relationship was observed , with long-term survivors who had received diagnoses in middle age ( 45 - 65 years ) showing better QOL outcomes in the physical domain and in overall QOL . Age at diagnosis and years of survival were significant predictors of QOL outcomes . CLINICAL IMPLICATION S These findings indicate that the life stage at diagnosis can help to predict long-term QOL outcomes in breast cancer survivors . Educational strategies to help oncology professionals develop a better underst and ing of the impact of age at diagnosis may be important in developing tailored interventions that respond to the specific needs of breast cancer survivors at each life stage 
    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: Women with breast cancer are one of the largest groups of cancer survivors . This research examined whether breast cancer has a long-term impact on quality of life ( QOL ) by comparing 5-year disease-free survivors to age-matched controls and by comparing women who sustained a recurrence to disease-free survivors . Controls  were recruited using the neighborhood control methodology .  QOL ( physical , emotional , social , and spiritual ) was assessed during in-person interviews . There were no differences between disease-free survivors ( n = 267 ) and controls ( n = 187 ) on many indicators of QOL . However , survivors reported more difficulties with physical functioning , more physical symptoms , and more faith than did controls ( all ps < 0.05 ) . Compared to disease-free survivors , survivors with a recurrence ( n = 37 ) had a worse QOL on most indices , less positive affect , more general fatigue , and more intrusive and avoidant thoughts ( all ps < 0.05 ) . There were no differences between the two groups of survivors on indices of marriage , work experiences , or spirituality . These findings suggest that the QOL of long-term survivors who remain disease-free is comparable to that of women their age with the exception of physical functioning . Women who sustain a recurrence suffer an impaired QOL in some , but not all , domains AIM This paper is a report of a study to describe the efficacy of cognitive behavioural therapy for insomnia on fatigue , mood and quality of life in breast cancer survivors . BACKGROUND Women who receive primary treatment for breast cancer often complain of insomnia . Rarely evaluated in insomnia intervention studies is the effect of cognitive behavioural treatment on the psychosocial outcomes of fatigue , mood and quality of life . METHOD Data were collected between December 2002 and March 2004 with 72 women who were at least 3 months post-completion of primary treatment without current evidence of disease . Women were r and omly assigned to either the cognitive behavioural therapy for insomnia group , which received stimulus control instructions , sleep restriction therapy and sleep education and hygiene , or the component control group which received sleep education and hygiene only . The 10-week study consisted of 2 weeks of pre-treatment , 6 weeks of treatment and 2 weeks of post-treatment . Fatigue , mood and quality of life were measured at pre- and post-treatment . FINDINGS Women receiving cognitive behavioural therapy for insomnia had significant improvements in fatigue , trait anxiety , depression and quality of life . The component control group also had statistically significant increases in quality of life , with a trend suggestive of lower depression at post-treatment . CONCLUSION Globally , as the number of survivors in this population continues to grow , it is imperative that nurses continue testing interventions that may positively affect quality of life and the commonly experienced symptoms of fatigue , anxiety and depression The  long‐term impact of breast carcinoma and its treatment was assessed in 153 breast carcinoma survivors previously treated on a Phase III r and omized trial ( Cancer and Leukemia Group B [ CALGB 7581 ] ) a median of 20 years after entry to CALGB 7581 The European Organisation for Research and Treatment of Cancer ( EORTC ) quality of life question naire QLQ-C30 has been developed as a quantitative measure of health-related quality of life for use in clinical trials of cancer patients . Validity is an important measurement property of all scientific tests . This study contributes to the iterative process of validating the question naire by focusing on the psychosocial subscales of the QLQ-C30 , using baseline data from 150 patients participating in a r and omised trial of supportive group therapy for metastatic breast cancer . The results provide strong support for the discriminative validity of the global health/ quality of life , role function and social function subscales of the  QLQ-C30  , in patients differing according to clinical criteria . The psychosocial focus of the trial enabled expansion of criteria used to form patient subgroups , beyond medical factors , and consequently support was demonstrated for the discriminative validity of the emotional and cognitive function subscales . The degree of support for these subscales was less substantial than for the other QLQ-C30 subscales as there were fewer relevant criteria . Convergence assessed by correlations with independent measures of psychosocial function provides strong support for the convergent validity of the emotional function , role function and global health/ quality of life subscales of the QLQ-C30 , and moderate support for the social function subscales . There was little opportunity for the cognitive function subscale to associate with conceptually analogous subscales . Further testing is recommended with more comprehensive and specific measures of cognitive status . In general , the psychosocial subscales of the QLQ-C30 appear to be measuring the concepts they are purported to measure The aim of this study was to evaluate the impact of a twice-weekly strength training intervention on perceptions of body image in 234 breast cancer survivors ( 112 with lymphedema ) who participated in the Physical Activity and Lymphedema ( PAL ) trial . The study population included two hundred and thirty-four women r and omly assigned to twice-weekly strength training or control group that completed the 32-item Body Image and Relationships Scale ( BIRS ) at baseline and 12 months . Percent change in baseline to 12-month BIRS total and subscale scores , upper and lower body strength , and general quality of life ( QOL ) were compared by intervention status . A series of multiple linear regression models including indicator variables for subgroups based on age , marital status , race , education , BMI , and strength change were used to examine differential intervention impact by subgroup . Strength and QOL variables were assessed as mediators of the intervention effect on BIRS . Results : Baseline BIRS scores were similar across intervention and lymphedema status . Significantly greater improvement in BIRS total score was observed from baseline to 12 months in treatment vs. control participants ( 12.0 vs. 2.0 % ; P < 0.0001 ) . A differential impact of the intervention on the Strength and Health subscale was observed for older women ( > 50 years old ) in the treatment group ( P = 0.03 ) . Significantly greater improvement was observed in bench and leg press among treatment group when compared to control group participants , regardless of lymphedema . Observed intervention effects were independent of observed strength and QOL changes . Twice-weekly strength training positively impacted self-perceptions of appearance , health , physical strength , sexuality , relationships , and social functioning . Evidence suggests the intervention was beneficial regardless of prior diagnosis of lymphedema . Strength and QOL improvements did not mediate the observed intervention effects PURPOSE The purpose of the study was to determine the relationship between life-stage variables ( ie , age at diagnosis and years of survival ) and quality -of-life ( QOL ) outcomes in long-term survivors of breast cancer . DESCRIPTION OF STUDY In this cross-sectional study , 105 long-term survivors of breast cancer participated in a mailed survey assessing QOL .  Participants were selected from a cancer center tumor registry using a stratified r and om-sampling procedure that was based on age at diagnosis . The  Quality of Life-Cancer Survivors scale was used to assess QOL outcomes in the physical , psychological , social , and spiritual domains . RESULTS Long-term survivors of breast cancer who had received diagnoses at an older age ( > 65 years ) showed significantly ( P < .05 ) worse QOL outcomes in the physical domain , while those who had received diagnoses at a younger age ( 27 - 44 years ) showed worse QOL outcomes in the social domain than other age groups . A nonlinear relationship was observed , with long-term survivors who had received diagnoses in middle age ( 45 - 65 years ) showing better QOL outcomes in the physical domain and in overall QOL . Age at diagnosis and years of survival were significant predictors of QOL outcomes . CLINICAL IMPLICATION S These findings indicate that the life stage at diagnosis can help to predict long-term QOL outcomes in breast cancer survivors . Educational strategies to help oncology professionals develop a better underst and ing of the impact of age at diagnosis may be important in developing tailored interventions that respond to the specific needs of breast cancer survivors at each life stage 
    Output:
    