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 : Despite expansion in palliative daycare services , research has not demonstrated an improvement in patient outcomes . This study aim ed to determine the effect of palliative daycare on hope . Methods : This was a prospect i ve cohort study that compared three groups of patients : a daycare group and two control groups , one recruited before daycare opened and a matched comparison group .  Patients were interviewed at baseline and at two follow-ups using the Herth Hope Index . Results : In all , 22 daycare patients completed a baseline interview ( T1 ) ; 12 a second ( T2 ) ; and 9 a third ( T3 ) . Corresponding numbers were : before group ( 56 , 34 , 24 ) and matched group ( 49 , 29 , 19 ) . An independent sample s t-test confirmed a significant difference between the groups from T1 to T2 ( mean difference=3.20 , p=0.007 ) , with the daycare group experiencing an increase in hope not seen in the other groups . However , this was not maintained . Conclusion : Daycare may effect an initial improvement in hope . The study suffered from attrition and the sample was small . Further robust evaluation of daycare is needed Background Web and mobile technologies appear to hold promise for delivering evidence -informed and evidence -based intervention to cancer survivors and others living with trauma and other psychological concerns .  Health-space.net was developed as a comprehensive online social networking and coping skills training program for cancer survivors living with distress . Purpose The purpose of this study was to evaluate the effects of a 12-week social networking intervention on distress , depression , anxiety , vigor , and fatigue in cancer survivors reporting high levels of cancer-related distress . Methods We recruited 347 participants from a local cancer registry and internet , and all were r and omized to either a 12-week waiting list control group or to immediate access to the intervention . Intervention participants received secure access to the study website , which provided extensive social networking capabilities and coping skills training exercises facilitated by a professional facilitator . Results Across time , the prevalence of clinical ly significant depression symptoms declined from 67 to 34 % in both conditions . The health-space.net intervention had greater declines in fatigue than the waitlist control group , but the intervention did not improve outcomes for depression , trauma-related anxiety symptoms , or overall mood disturbance . For those with more severe levels of anxiety at baseline , greater engagement with the intervention was associated with higher levels of symptom reduction over time . Conclusions The intervention result ed in small but significant effects on fatigue but not other primary or secondary outcomes . Results suggest that this social networking intervention may be most effective for those who have distress that is not associated with high levels of anxiety symptoms or very poor overall psychological functioning . Trial Registration NumberThe trial was registered with the Clinical Trials.gov data base ( Clinical Trials.gov # NCT01976949 ) The adoption of evidence -based hierarchies and research methods from other disciplines may not completely translate to complex palliative care setting s. The heterogeneity of the palliative care population , complexity of clinical presentations , and fluctuating health states present significant research challenges . The aim of this narrative review was to explore the debate about the use of current evidence -based approaches for conducting research , such as r and omized controlled trials and other study design s , in palliative care , and more specifically to ( 1 ) describe key myths about palliative care research ; ( 2 ) highlight substantive challenges of conducting palliative care research , using case illustrations ; and ( 3 ) propose specific strategies to address some of these challenges . Myths about research in palliative care revolve around evidence hierarchies , sample heterogeneity , r and om assignment , participant burden , and measurement issues . Challenges arise because of the complex physical , psychological , existential , and spiritual problems faced by patients , families , and service providers . These challenges can be organized according to six general domains : patient , system/organization , context / setting , study design , research team , and ethics . A number of approaches for dealing with challenges in conducting research fall into five separate domains : study design , sampling , conceptual , statistical , and measures and outcomes . Although r and omized controlled trials have their place whenever possible , alternative design s may offer more feasible research protocol s that can be successfully implemented in palliative care . Therefore , this article highlights " outside the box " approaches that would benefit both clinicians and research ers in the palliative care field . Ultimately , the selection of research design s is dependent on a clearly articulated research question , which drives the research process OBJECTIVE There are significant burdens associated with providing care for loved ones with cancer . However , caregiver quality of life ( QOL ) is often overlooked . With the increasing number of older adults with cancer , it is important to determine whether a patient 's age and QOL have any association with the caregiver 's QOL . The objective of our study was to describe caregiver QOL and explore whether patient age and other psychosocial factors impact caregiver QOL . MATERIAL S AND METHODS Baseline information from patients with advanced cancer undergoing radiation and their caregivers , who were enrolled in a r and omized , controlled clinical trial to test the effectiveness of a structured , multidisciplinary QOL intervention , was analyzed for this study . Caregivers completed the Caregiver Quality of Life Index-Cancer ( CQOLC ) Scale . Both patients and caregivers completed the  Linear Analogue Self- Assessment ( LASA ) to measure QOL , and Profile of Mood States ( POMS ) to measure mood states . RESULTS Overall , 131 patient-caregiver pairs participated in the study . At baseline , caregivers of older adults ( ≥65years ) had higher mental ( P=0.01 ) , emotional ( P=0.003 ) , spiritual ( P<0.01 ) , and social support ( P=0.03 ) LASA QOL scores . Caregivers of older adults also had higher baseline QOL ( CQOLC , P=0.003 ) and mood ( POMS , P=0.04 ) than caregivers of younger adults . Caregivers of patients with higher LASA QOL scores had higher overall ( P=0.02 ) , mental ( P=0.006 ) , physical ( P=0.02 ) , emotional ( P=0.002 ) , and spiritual LASA QOL scores ( P=0.047 ) . CONCLUSIONS Caregivers of older adults with advanced cancer demonstrated better QOL and fewer mood disturbances compared to caregivers of younger patients . When patients have good QOL , caregivers also had good QOL Abstract Background : Patients with advanced cancer face multiple challenges to their quality of life ( QOL ) . The goal of this study was to investigate the impact of participation in a multidisciplinary intervention , including a social service component , on improving the QOL of patients with advanced cancer undergoing radiation therapy . Design : A total of 115 participants with newly diagnosed advanced stage cancer , who were receiving radiation therapy  , were r and omly assigned to either participate in an 8-session structured multidisciplinary intervention or to receive st and ard care . Each 90-minute session was led by either a psychologist or psychiatrist and co-led with a nurse , physical therapist , chaplain , and /or social worker . The sessions were design ed to address the domains that impact QOL : emotional , spiritual , physical , and social domains ( support , community re sources , financial and legal issues , and advance directives ) . QOL was assessed , at baseline , 4 ( end of treatment ) , 8 and 27 weeks . The primary endpoint was overall QOL assessed on a 0–100 scale at Week 4 . Results : A total of 115 patients were enrolled from October 2 , 2000 to October 28 , 2002 .  Overall QOL at Week 4 averaged 10 points higher in the intervention group than in the control group ( 80 vs. 70 points , p = 0.047 ) which was an increase of 3 % from baseline in the intervention group versus a decrease of 9 % in the control group ( p = 0.009 ) . Of the subscores reflecting patient 's opinion regarding their QOL , there was improvement in all social domains which contributed to the overall improvement in QOL . Significant changes from baseline to Week 4 scores were seen in the areas of financial concerns ( p = 0.025 ) and legal issues ( p = 0.048 ) . Conclusions : A social work component within a structured multi-disciplinary intervention results in significant advantages in the social domain of QOL , and contributes to clinical ly meaningful improvements in the overall QOL for patients with advanced cancer undergoing active medical treatment . Numerous studies have documented the financial burdens and social changes that may occur with the diagnosis of cancer . However , previous research has not examined the role of a social worker in providing financial , social , and legal education , in a structured multidisciplinary intervention , and its direct impact on QOL . Outlined in this paper is the role of the medical social worker in a clinical trial , how education was provided and strategies for future interventions Purpose Cancer treatment can profoundly impact the patient ’s quality of life ( QOL ) . It has been well documented that there are gender differences in the symptoms associated with cancer treatment . This study explores the impact of gender on QOL for patients with newly diagnosed advanced cancer . Methods A r and omized , controlled clinical trial in patients receiving radiotherapy for advanced cancer demonstrated maintenance of QOL with a six session multidisciplinary structured intervention compared to controls . This current study reports the gender differences in that trial . Outcome measures included the functional assessment of cancer therapy-general ( FACT-G ) , linear analog self- assessment ( LASA ) , and profile of mood states ( POMS ) at baseline and weeks 4 , 27 , and 52 . Kruskal – Wallis was used to compare QOL scores . Results One hundred thirty-one patients ( 45 women and 86 men , mean age 58.7 ) participated in the clinical trial . At week 4 postintervention , women in the intervention group had statistically significant improvement in their FACT-G score , FACT-G physical well-being subscale , LASA fatigue , POMS total score , POMS fatigue – inertia subscale , and POMS confusion – bewilderment subscale ( p < 0.05 ) . Men receiving the intervention had a smaller decrease in FACT-G score compared to controls ( p = 0.048 ) and also worsened on the LASA financial ( p = 0.02 ) . At week 27 , the only gender difference was that intervention group men had more POMS anger – hostility ( p = 0.009 ) . By week 52 , there were no statistically significant gender differences in any of the QOL measures . Conclusions Gender-based differences appear to play a role in the early , but not late , response to a multidisciplinary intervention to improve QOL for patients with advanced cancer , suggesting that early interventions can be tailored for each gender BACKGROUND Attention to psycho-socio-spiritual needs is considered critical by patients with life-threatening illnesses and their caregivers .  Palliative care interventions that address these needs -- particularly spirituality -- are lacking . OBJECTIVE To evaluate the effects of an innovative program to address psycho-socio-spiritual needs in patients with life-threatening illnesses . DESIGN A group intervention entitled Life-Threatening Illness Supportive-Affective Group Experience ( LTI-SAGE ) was developed for reducing patient spiritual , emotional , and death-related distress . SETTING /SUBJECTS African American and Caucasian patients ( n = 69 ) from two hospitals in St. Louis , Missouri , with life-threatening medical conditions ( cancer ; human immunodeficiency virus/acquired immune deficiency syndrome [ HIV/AIDS ] ; geriatric frailty ; liver , kidney , pulmonary , or cardiovascular disease ) were r and omly assigned to intervention or control groups . Intervention patients participated in a maximum of 12 LTI-SAGE groups over a 12-month period . Control patients received st and ard care . MEASUREMENTS Outcome measures were depression symptoms , anxiety , spiritual well-being , and death-related emotional distress . RESULTS After attrition , 51 ( 73.9 % ) patients completed the trial . At the end of the trial , after factoring in compliance , intervention patients had significantly fewer depression symptoms and death-related feelings of meaninglessness and significantly better spiritual well-being than did control patients . CONCLUSIONS The use of the LTI-SAGE model for enhancing the end-of-life illness experience is promising Objectives : This study examined relations between social isolation , loneliness , and social support to health outcomes in a sample of New Mexico seniors . Method : We used r and om-digit dialing to obtain a r and om sample of 755 southern New Mexico seniors . Participants answered questions pertaining to demographics , social isolation and loneliness , social support , and disease diagnosis including diabetes , hypertension , heart disease , liver disease , arthritis , emphysema , tuberculosis , kidney disease , cancer , asthma , and stroke . The sample allowed for comparison of Caucasian and Hispanic participants . Results : Correlational and logistic analyses indicated that belongingness support related most consistently to health outcomes . Ethnic subgroup analysis revealed similarities and differences in the pattern of associations among the predictor and outcome variables . Discussion : The results demonstrate the importance of social variables for predicting disease outcomes in the elderly and across ethnic groups Cheville AL , Girardi J , Clark MM , Rummans TA , Pittelkow T , Brown P , Hanson J , Atherton P , Johnson ME , Sloan JA , Gamble G : Therapeutic exercise during outpatient radiation therapy for advanced cancer : Feasibility and impact on physical well-being . Objective : To characterize the feasibility of delivering a structured physical therapy ( PT ) program as part of a multidisciplinary intervention to patients undergoing outpatient radiation therapy for advanced cancer . Design : A single-blinded , r and omized , controlled trial at a quaternary medical center outpatient clinic . One hundred three adults undergoing radiation therapy for advanced cancer with pro 
    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: Background : Despite expansion in palliative daycare services , research has not demonstrated an improvement in patient outcomes . This study aim ed to determine the effect of palliative daycare on hope . Methods : This was a prospect i ve cohort study that compared three groups of patients : a daycare group and two control groups , one recruited before daycare opened and a matched comparison group .  Patients were interviewed at baseline and at two follow-ups using the Herth Hope Index . Results : In all , 22 daycare patients completed a baseline interview ( T1 ) ; 12 a second ( T2 ) ; and 9 a third ( T3 ) . Corresponding numbers were : before group ( 56 , 34 , 24 ) and matched group ( 49 , 29 , 19 ) . An independent sample s t-test confirmed a significant difference between the groups from T1 to T2 ( mean difference=3.20 , p=0.007 ) , with the daycare group experiencing an increase in hope not seen in the other groups . However , this was not maintained . Conclusion : Daycare may effect an initial improvement in hope . The study suffered from attrition and the sample was small . Further robust evaluation of daycare is needed Background Web and mobile technologies appear to hold promise for delivering evidence -informed and evidence -based intervention to cancer survivors and others living with trauma and other psychological concerns .  Health-space.net was developed as a comprehensive online social networking and coping skills training program for cancer survivors living with distress . Purpose The purpose of this study was to evaluate the effects of a 12-week social networking intervention on distress , depression , anxiety , vigor , and fatigue in cancer survivors reporting high levels of cancer-related distress . Methods We recruited 347 participants from a local cancer registry and internet , and all were r and omized to either a 12-week waiting list control group or to immediate access to the intervention . Intervention participants received secure access to the study website , which provided extensive social networking capabilities and coping skills training exercises facilitated by a professional facilitator . Results Across time , the prevalence of clinical ly significant depression symptoms declined from 67 to 34 % in both conditions . The health-space.net intervention had greater declines in fatigue than the waitlist control group , but the intervention did not improve outcomes for depression , trauma-related anxiety symptoms , or overall mood disturbance . For those with more severe levels of anxiety at baseline , greater engagement with the intervention was associated with higher levels of symptom reduction over time . Conclusions The intervention result ed in small but significant effects on fatigue but not other primary or secondary outcomes . Results suggest that this social networking intervention may be most effective for those who have distress that is not associated with high levels of anxiety symptoms or very poor overall psychological functioning . Trial Registration NumberThe trial was registered with the Clinical Trials.gov data base ( Clinical Trials.gov # NCT01976949 ) The adoption of evidence -based hierarchies and research methods from other disciplines may not completely translate to complex palliative care setting s. The heterogeneity of the palliative care population , complexity of clinical presentations , and fluctuating health states present significant research challenges . The aim of this narrative review was to explore the debate about the use of current evidence -based approaches for conducting research , such as r and omized controlled trials and other study design s , in palliative care , and more specifically to ( 1 ) describe key myths about palliative care research ; ( 2 ) highlight substantive challenges of conducting palliative care research , using case illustrations ; and ( 3 ) propose specific strategies to address some of these challenges . Myths about research in palliative care revolve around evidence hierarchies , sample heterogeneity , r and om assignment , participant burden , and measurement issues . Challenges arise because of the complex physical , psychological , existential , and spiritual problems faced by patients , families , and service providers . These challenges can be organized according to six general domains : patient , system/organization , context / setting , study design , research team , and ethics . A number of approaches for dealing with challenges in conducting research fall into five separate domains : study design , sampling , conceptual , statistical , and measures and outcomes . Although r and omized controlled trials have their place whenever possible , alternative design s may offer more feasible research protocol s that can be successfully implemented in palliative care . Therefore , this article highlights " outside the box " approaches that would benefit both clinicians and research ers in the palliative care field . Ultimately , the selection of research design s is dependent on a clearly articulated research question , which drives the research process OBJECTIVE There are significant burdens associated with providing care for loved ones with cancer . However , caregiver quality of life ( QOL ) is often overlooked . With the increasing number of older adults with cancer , it is important to determine whether a patient 's age and QOL have any association with the caregiver 's QOL . The objective of our study was to describe caregiver QOL and explore whether patient age and other psychosocial factors impact caregiver QOL . MATERIAL S AND METHODS Baseline information from patients with advanced cancer undergoing radiation and their caregivers , who were enrolled in a r and omized , controlled clinical trial to test the effectiveness of a structured , multidisciplinary QOL intervention , was analyzed for this study . Caregivers completed the Caregiver Quality of Life Index-Cancer ( CQOLC ) Scale . Both patients and caregivers completed the  Linear Analogue Self- Assessment ( LASA ) to measure QOL , and Profile of Mood States ( POMS ) to measure mood states . RESULTS Overall , 131 patient-caregiver pairs participated in the study . At baseline , caregivers of older adults ( ≥65years ) had higher mental ( P=0.01 ) , emotional ( P=0.003 ) , spiritual ( P<0.01 ) , and social support ( P=0.03 ) LASA QOL scores . Caregivers of older adults also had higher baseline QOL ( CQOLC , P=0.003 ) and mood ( POMS , P=0.04 ) than caregivers of younger adults . Caregivers of patients with higher LASA QOL scores had higher overall ( P=0.02 ) , mental ( P=0.006 ) , physical ( P=0.02 ) , emotional ( P=0.002 ) , and spiritual LASA QOL scores ( P=0.047 ) . CONCLUSIONS Caregivers of older adults with advanced cancer demonstrated better QOL and fewer mood disturbances compared to caregivers of younger patients . When patients have good QOL , caregivers also had good QOL Abstract Background : Patients with advanced cancer face multiple challenges to their quality of life ( QOL ) . The goal of this study was to investigate the impact of participation in a multidisciplinary intervention , including a social service component , on improving the QOL of patients with advanced cancer undergoing radiation therapy . Design : A total of 115 participants with newly diagnosed advanced stage cancer , who were receiving radiation therapy  , were r and omly assigned to either participate in an 8-session structured multidisciplinary intervention or to receive st and ard care . Each 90-minute session was led by either a psychologist or psychiatrist and co-led with a nurse , physical therapist , chaplain , and /or social worker . The sessions were design ed to address the domains that impact QOL : emotional , spiritual , physical , and social domains ( support , community re sources , financial and legal issues , and advance directives ) . QOL was assessed , at baseline , 4 ( end of treatment ) , 8 and 27 weeks . The primary endpoint was overall QOL assessed on a 0–100 scale at Week 4 . Results : A total of 115 patients were enrolled from October 2 , 2000 to October 28 , 2002 .  Overall QOL at Week 4 averaged 10 points higher in the intervention group than in the control group ( 80 vs. 70 points , p = 0.047 ) which was an increase of 3 % from baseline in the intervention group versus a decrease of 9 % in the control group ( p = 0.009 ) . Of the subscores reflecting patient 's opinion regarding their QOL , there was improvement in all social domains which contributed to the overall improvement in QOL . Significant changes from baseline to Week 4 scores were seen in the areas of financial concerns ( p = 0.025 ) and legal issues ( p = 0.048 ) . Conclusions : A social work component within a structured multi-disciplinary intervention results in significant advantages in the social domain of QOL , and contributes to clinical ly meaningful improvements in the overall QOL for patients with advanced cancer undergoing active medical treatment . Numerous studies have documented the financial burdens and social changes that may occur with the diagnosis of cancer . However , previous research has not examined the role of a social worker in providing financial , social , and legal education , in a structured multidisciplinary intervention , and its direct impact on QOL . Outlined in this paper is the role of the medical social worker in a clinical trial , how education was provided and strategies for future interventions Purpose Cancer treatment can profoundly impact the patient ’s quality of life ( QOL ) . It has been well documented that there are gender differences in the symptoms associated with cancer treatment . This study explores the impact of gender on QOL for patients with newly diagnosed advanced cancer . Methods A r and omized , controlled clinical trial in patients receiving radiotherapy for advanced cancer demonstrated maintenance of QOL with a six session multidisciplinary structured intervention compared to controls . This current study reports the gender differences in that trial . Outcome measures included the functional assessment of cancer therapy-general ( FACT-G ) , linear analog self- assessment ( LASA ) , and profile of mood states ( POMS ) at baseline and weeks 4 , 27 , and 52 . Kruskal – Wallis was used to compare QOL scores . Results One hundred thirty-one patients ( 45 women and 86 men , mean age 58.7 ) participated in the clinical trial . At week 4 postintervention , women in the intervention group had statistically significant improvement in their FACT-G score , FACT-G physical well-being subscale , LASA fatigue , POMS total score , POMS fatigue – inertia subscale , and POMS confusion – bewilderment subscale ( p < 0.05 ) . Men receiving the intervention had a smaller decrease in FACT-G score compared to controls ( p = 0.048 ) and also worsened on the LASA financial ( p = 0.02 ) . At week 27 , the only gender difference was that intervention group men had more POMS anger – hostility ( p = 0.009 ) . By week 52 , there were no statistically significant gender differences in any of the QOL measures . Conclusions Gender-based differences appear to play a role in the early , but not late , response to a multidisciplinary intervention to improve QOL for patients with advanced cancer , suggesting that early interventions can be tailored for each gender BACKGROUND Attention to psycho-socio-spiritual needs is considered critical by patients with life-threatening illnesses and their caregivers .  Palliative care interventions that address these needs -- particularly spirituality -- are lacking . OBJECTIVE To evaluate the effects of an innovative program to address psycho-socio-spiritual needs in patients with life-threatening illnesses . DESIGN A group intervention entitled Life-Threatening Illness Supportive-Affective Group Experience ( LTI-SAGE ) was developed for reducing patient spiritual , emotional , and death-related distress . SETTING /SUBJECTS African American and Caucasian patients ( n = 69 ) from two hospitals in St. Louis , Missouri , with life-threatening medical conditions ( cancer ; human immunodeficiency virus/acquired immune deficiency syndrome [ HIV/AIDS ] ; geriatric frailty ; liver , kidney , pulmonary , or cardiovascular disease ) were r and omly assigned to intervention or control groups . Intervention patients participated in a maximum of 12 LTI-SAGE groups over a 12-month period . Control patients received st and ard care . MEASUREMENTS Outcome measures were depression symptoms , anxiety , spiritual well-being , and death-related emotional distress . RESULTS After attrition , 51 ( 73.9 % ) patients completed the trial . At the end of the trial , after factoring in compliance , intervention patients had significantly fewer depression symptoms and death-related feelings of meaninglessness and significantly better spiritual well-being than did control patients . CONCLUSIONS The use of the LTI-SAGE model for enhancing the end-of-life illness experience is promising Objectives : This study examined relations between social isolation , loneliness , and social support to health outcomes in a sample of New Mexico seniors . Method : We used r and om-digit dialing to obtain a r and om sample of 755 southern New Mexico seniors . Participants answered questions pertaining to demographics , social isolation and loneliness , social support , and disease diagnosis including diabetes , hypertension , heart disease , liver disease , arthritis , emphysema , tuberculosis , kidney disease , cancer , asthma , and stroke . The sample allowed for comparison of Caucasian and Hispanic participants . Results : Correlational and logistic analyses indicated that belongingness support related most consistently to health outcomes . Ethnic subgroup analysis revealed similarities and differences in the pattern of associations among the predictor and outcome variables . Discussion : The results demonstrate the importance of social variables for predicting disease outcomes in the elderly and across ethnic groups Cheville AL , Girardi J , Clark MM , Rummans TA , Pittelkow T , Brown P , Hanson J , Atherton P , Johnson ME , Sloan JA , Gamble G : Therapeutic exercise during outpatient radiation therapy for advanced cancer : Feasibility and impact on physical well-being . Objective : To characterize the feasibility of delivering a structured physical therapy ( PT ) program as part of a multidisciplinary intervention to patients undergoing outpatient radiation therapy for advanced cancer . Design : A single-blinded , r and omized , controlled trial at a quaternary medical center outpatient clinic . One hundred three adults undergoing radiation therapy for advanced cancer with pro 
    Output:
    