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: Research suggests that stress‐reduction programs tailored to the cancer setting help patients cope with the effects of treatment and improve their quality of life .  Yoga , an ancient Eastern science , incorporates stress‐reduction techniques that include regulated breathing , visual imagery , and meditation as well as various postures . The authors examined the effects of the  Tibetan yoga ( TY ) practice s of Tsa lung and Trul khor , which incorporate  controlled breathing and visualization , mindfulness techniques  , and low‐impact postures  in patients with lymphoma Until now , little research has been conducted examining the reactive dimension , or the degree to which a symptom limits an individual 's life , in a multiplicity of symptoms . This research examines how problem-solving therapy organizes an intervention to decrease symptom limitations . The purpose was threefold : to determine if a cognitive behavioral intervention decreases the impact of symptom limitations among individuals newly diagnosed with cancer , who are receiving chemotherapy ; to determine , after adjusting for covariates , how symptom limitations change over time ; and to describe which symptoms are most limiting . This r and omized control trial was conducted in two comprehensive and four community cancer centers . Two hundred thirty-seven individuals , aged 31 - 87 , newly diagnosed with solid tumor cancers , participated . The experimental group ( 118 individuals ) received a 10-contact , 18-week cognitive behavioral intervention focused on cancer- and chemotherapy-related symptoms . The control group ( 119 individuals ) received conventional care . Interviews occurred at baseline , 10 , 20 , and 32 weeks . Data analysis used a two-level hierarchical linear model . Participants receiving the cognitive behavioral intervention had lower scores of symptom limitation than did participants in the control group . At the onset of the study , younger patients reported more symptom limitations than their older counterparts ; however , this was reversed by the end of the study . The cognitive behavioral intervention was key to decreasing symptom limitations . Findings also suggest that nursing interventions may be particularly helpful to younger individuals in managing cancer-related symptom limitations OBJECTIVE Women with gynecological cancers have reported poor health-related quality of life ( QOL ) , with complex physical and psychological needs post-surgery and during chemotherapy treatment . There are no studies reporting interventions addressing these needs post-hospital discharge in this population . METHODS Patients were r and omized into two groups . The intervention group received 6 months of specialized care by an Advanced Practice Nurse ( APN ) ; in addition , women with high distress were evaluated and monitored by a psychiatric consultation-liaison nurse ( PCLN ) . The attention control group was assisted with symptom management by a research assistant . The effects of the 6-month intervention were evaluated using self-report question naires at baseline ( 24 - 48 h after surgery ) , 1 , 3 , and 6 months post- surgery . QOL assessment s included the Center for Epidemiological Studies -Depression Scale , the ambiguity subscale of the Mishel Uncertainty in Illness Scale , the Symptom Distress Scale , and the Short-Form Health Survey ( SF-12 ) . The sample for the longitudinal analysis included 123 who completed QOL outcome measures  across three occasions post-surgery . RESULTS The APN intervention result ed in significantly less uncertainty than the attention control intervention 6 months after surgery . When the sub-group who received the APN plus PCLN intervention was compared with the total attention control group , the sub-group had significantly less uncertainty , less symptom distress , and better SF-12 mental and physical QOL over time . CONCLUSION Nurse tailored interventions that target both physical and psychological aspects of QOL in women recovering from cancer surgery and undergoing chemotherapy produce stronger outcomes than interventions that target solely one QOL aspect PURPOSE Evidence suggests that the re-entry phase ( ie , early period after medical treatment completion ) presents distinct challenges for cancer patients . To facilitate the transition to recovery , we conducted the Moving Beyond Cancer ( MBC ) trial , a multisite , r and omized , controlled trial of psychoeducational interventions for breast cancer patients . METHODS Breast cancer patients were registered within 6 weeks after surgery . After medical treatment , they completed baseline measures and were r and omly assigned to st and ard National Cancer Institute print material ( CTL ) ; st and ard print material and peer-modeling videotape ( VID ) ; or st and ard print material , videotape , two sessions with a trained cancer educator , and informational workbook ( EDU ) . Two primary end points were examined : energy/fatigue and cancer-specific distress . Secondary end points were depressive symptoms and post-traumatic growth . Perceived preparedness for re-entry was analyzed as a moderator of effects . RESULTS Of 558 women r and omly assigned to treatment , 418 completed the 6-month assessment and 399 completed the 12-month assessment . In analyses controlling for study site and baseline depressive symptoms , VID produced significant improvement in energy/fatigue at 6 months relative to CTL , particularly among women who felt less prepared for re-entry at baseline . No significant main effect of the interventions emerged on cancer-specific distress , but EDU prompted greater reduction in this outcome relative to CTL at 6 months for patients who felt more prepared for re-entry . Between-group differences in the primary outcomes were not significant at 12 months , and no significant effects emerged on the secondary end points . CONCLUSION A peer-modeling videotape can accelerate the recovery of energy during the re-entry phase in women treated for breast cancer , particularly among those who feel less prepared for re-entry BACKGROUND Physical activity provides a number of physical and psychological benefits to cancer survivors , including lessening the impact of detrimental cancer-related symptoms and treatment side-effects ( e.g. fatigue , nausea ) , and improving overall well-being and quality of life . The purpose of the present pilot study was to examine the physical and psychological benefits afforded by a 7-week yoga program for cancer survivors . METHOD Eligible participants ( per-screened with PAR-Q/PAR-MED-X ) were r and omly assigned to either the  intervention ( n=20 ) or control group ( n=18 ) . All participants completed pre- and post-testing assessment s immediately before and after the yoga program , respectively . RESULTS The yoga program participants ( M age=51.18 ( 10.33 ) ; 92 % female ) included primarily breast cancer survivors , on average 55.95 ( 54.39 ) months post-diagnosis . Significant differences between the intervention and the control group at post-intervention were seen only in psychosocial ( i.e. global quality of life , emotional function , and diarrhea ) variables ( all p 's < 0.05 ) . There were also trends for group differences , in the hypothesized directions , for the psychosocial variables of emotional irritability , gastrointestinal symptoms , cognitive disorganization , mood disturbance , tension , depression , and confusion ( all p 's < 0.10 ) . Finally , there were also significant improvements in both the program participants and the controls from pre- to post-intervention on a number of physical fitness variables . CONCLUSIONS These initial findings suggest that yoga has significant potential and should be further explored as a beneficial physical activity option for cancer survivors . Future research might attempt to include a broader range of participants ( e.g. other types of cancer diagnoses , male subjects ) , a larger sample size , and a longer program duration in an RCT OBJECTIVE Oral cancer elicits considerable distress in both the pre and post-treatment periods . This paper details the development , validation and pilot-testing of a psychoeducational intervention for oral cancer patients . METHOD An educational booklet covering information about oral cancer and its treatment and effective coping strategies was developed by a multi-disciplinary team . It was evaluated by patient focus groups and content/educational experts , delivered to subjects in pre and post-operative presentations by a health educator , and pilot-tested in a r and omized controlled trial versus st and ard care . RESULTS Pilot data from 19 subjects ( 10 psychoeducation , nine st and ard care )  indicates that the intervention is feasible and highly acceptable . At follow-up the intervention group showed a gain in knowledge , less body image disturbance , lower anxiety and a trend toward higher wellbeing . CONCLUSION This program , which is currently being evaluated in a larger RCT with extended follow-up , should prove useful in reducing the psychosocial burden of oral cancer and its treatment 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 BACKGROUND Major depressive disorder severely impairs the quality of life of patients with medical disorders such as cancer , but evidence to guide its management is scarce . We aim ed to assess the efficacy and cost of a nurse-delivered complex intervention that was design ed to treat major depressive disorder in patients who have cancer . METHODS We did a r and omised trial in a regional cancer centre in Scotl and , UK . 200 out patients who had cancer with a prognosis of greater than 6 months and major depressive disorder ( identified by screening ) were eligible and agreed to take part . Their mean age was 56.6 ( SD 11.9 ) years , and 141 ( 71 % ) were women . We r and omly assigned 99 of these participants to usual care , and 101 to usual care plus the intervention , with minimisation for sex , age , diagnosis , and extent of disease . The intervention was delivered by a cancer nurse at the centre over an average of seven sessions . The primary outcome was the difference in mean score on the self-reported Symptom Checklist-20 depression scale ( range 0 to 4 ) at 3 months after r and omisation . Analysis was by intention to treat . This trial is registered as IS RCT N84767225 . FINDINGS Primary outcome data were missing for four patients . For 196 patients for whom we had data at 3 months , the adjusted difference in mean Symptom Checklist-20 depression score , between those who received the intervention and those who did not , was 0.34 ( 95 % CI 0.13 - 0.55 ) . This treatment effect was sustained at 6 and 12 months . The intervention also improved anxiety and fatigue but not pain or physical functioning . It cost an additional pound sterling 5278 ( US$ 10 556 ) per quality -adjusted life-year gained . INTERPRETATION The intervention-Depression Care for People with Cancer-offers a model for the management of major depressive disorder in patients with cancer and other medical disorders who are attending specialist medical services that is feasible , acceptable , and potentially cost effective The potential benefits of health-related quality of life ( HRQL ) assessment in oncology clinical practice include better detection of problems , enhanced disease and treatment monitoring and improved care . However , few empirical studies have investigated the effects of incorporating such assessment s into routine clinical care . Recent r and omized studies have reported improved detection of and communication about patients ' concerns , but few have found effects on patient HRQL or satisfaction . This study examined whether offering interpretive assistance of HRQL results would improve these patient outcomes . Two hundred and thirteen participants with metastatic breast , lung or colorectal cancer were r and omly assigned to one of three conditions : usual care ; HRQL assessment or HRQL assessment followed by a structured interview and discussion . Interviews about patients ' assessment responses were conducted by a research nurse , who then presented HRQL information to the treating nurse . HRQL and treatment satisfaction outcomes were assessed at 3 and 6 months . No significant differences were found between study conditions in HRQL or satisfaction . Results suggest that routine HRQL assessment , even with description of results , is insufficient to improve patient HRQL and satisfaction . It is suggested that positive effects may require supplementing assessment results with specific suggestions for clinical management changes BACKGROUND We conducted a r and omised , controlled trial of cognitive-existential group therapy ( CEGT ) for women with early stage breast cancer receiving adjuvant chemotherapy with the aim of improving mood and mental attitude to cancer . METHODS Women were r and omised to 20 sessions of weekly group therapy plus 3 relaxation classes or to a control arm receiving 3 relaxation classes . Assessment s , independently done at baseline , 6 and 12 months , included a structured psychiatric interview and vali date d question naires covering mood , attitudes to cancer , family relationships , and satisfaction with therapy . RESULTS Three hundred and three of 491 ( 62 % ) eligible patients participated over 3 years .  Distress was 
    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: Research suggests that stress‐reduction programs tailored to the cancer setting help patients cope with the effects of treatment and improve their quality of life .  Yoga , an ancient Eastern science , incorporates stress‐reduction techniques that include regulated breathing , visual imagery , and meditation as well as various postures . The authors examined the effects of the  Tibetan yoga ( TY ) practice s of Tsa lung and Trul khor , which incorporate  controlled breathing and visualization , mindfulness techniques  , and low‐impact postures  in patients with lymphoma Until now , little research has been conducted examining the reactive dimension , or the degree to which a symptom limits an individual 's life , in a multiplicity of symptoms . This research examines how problem-solving therapy organizes an intervention to decrease symptom limitations . The purpose was threefold : to determine if a cognitive behavioral intervention decreases the impact of symptom limitations among individuals newly diagnosed with cancer , who are receiving chemotherapy ; to determine , after adjusting for covariates , how symptom limitations change over time ; and to describe which symptoms are most limiting . This r and omized control trial was conducted in two comprehensive and four community cancer centers . Two hundred thirty-seven individuals , aged 31 - 87 , newly diagnosed with solid tumor cancers , participated . The experimental group ( 118 individuals ) received a 10-contact , 18-week cognitive behavioral intervention focused on cancer- and chemotherapy-related symptoms . The control group ( 119 individuals ) received conventional care . Interviews occurred at baseline , 10 , 20 , and 32 weeks . Data analysis used a two-level hierarchical linear model . Participants receiving the cognitive behavioral intervention had lower scores of symptom limitation than did participants in the control group . At the onset of the study , younger patients reported more symptom limitations than their older counterparts ; however , this was reversed by the end of the study . The cognitive behavioral intervention was key to decreasing symptom limitations . Findings also suggest that nursing interventions may be particularly helpful to younger individuals in managing cancer-related symptom limitations OBJECTIVE Women with gynecological cancers have reported poor health-related quality of life ( QOL ) , with complex physical and psychological needs post-surgery and during chemotherapy treatment . There are no studies reporting interventions addressing these needs post-hospital discharge in this population . METHODS Patients were r and omized into two groups . The intervention group received 6 months of specialized care by an Advanced Practice Nurse ( APN ) ; in addition , women with high distress were evaluated and monitored by a psychiatric consultation-liaison nurse ( PCLN ) . The attention control group was assisted with symptom management by a research assistant . The effects of the 6-month intervention were evaluated using self-report question naires at baseline ( 24 - 48 h after surgery ) , 1 , 3 , and 6 months post- surgery . QOL assessment s included the Center for Epidemiological Studies -Depression Scale , the ambiguity subscale of the Mishel Uncertainty in Illness Scale , the Symptom Distress Scale , and the Short-Form Health Survey ( SF-12 ) . The sample for the longitudinal analysis included 123 who completed QOL outcome measures  across three occasions post-surgery . RESULTS The APN intervention result ed in significantly less uncertainty than the attention control intervention 6 months after surgery . When the sub-group who received the APN plus PCLN intervention was compared with the total attention control group , the sub-group had significantly less uncertainty , less symptom distress , and better SF-12 mental and physical QOL over time . CONCLUSION Nurse tailored interventions that target both physical and psychological aspects of QOL in women recovering from cancer surgery and undergoing chemotherapy produce stronger outcomes than interventions that target solely one QOL aspect PURPOSE Evidence suggests that the re-entry phase ( ie , early period after medical treatment completion ) presents distinct challenges for cancer patients . To facilitate the transition to recovery , we conducted the Moving Beyond Cancer ( MBC ) trial , a multisite , r and omized , controlled trial of psychoeducational interventions for breast cancer patients . METHODS Breast cancer patients were registered within 6 weeks after surgery . After medical treatment , they completed baseline measures and were r and omly assigned to st and ard National Cancer Institute print material ( CTL ) ; st and ard print material and peer-modeling videotape ( VID ) ; or st and ard print material , videotape , two sessions with a trained cancer educator , and informational workbook ( EDU ) . Two primary end points were examined : energy/fatigue and cancer-specific distress . Secondary end points were depressive symptoms and post-traumatic growth . Perceived preparedness for re-entry was analyzed as a moderator of effects . RESULTS Of 558 women r and omly assigned to treatment , 418 completed the 6-month assessment and 399 completed the 12-month assessment . In analyses controlling for study site and baseline depressive symptoms , VID produced significant improvement in energy/fatigue at 6 months relative to CTL , particularly among women who felt less prepared for re-entry at baseline . No significant main effect of the interventions emerged on cancer-specific distress , but EDU prompted greater reduction in this outcome relative to CTL at 6 months for patients who felt more prepared for re-entry . Between-group differences in the primary outcomes were not significant at 12 months , and no significant effects emerged on the secondary end points . CONCLUSION A peer-modeling videotape can accelerate the recovery of energy during the re-entry phase in women treated for breast cancer , particularly among those who feel less prepared for re-entry BACKGROUND Physical activity provides a number of physical and psychological benefits to cancer survivors , including lessening the impact of detrimental cancer-related symptoms and treatment side-effects ( e.g. fatigue , nausea ) , and improving overall well-being and quality of life . The purpose of the present pilot study was to examine the physical and psychological benefits afforded by a 7-week yoga program for cancer survivors . METHOD Eligible participants ( per-screened with PAR-Q/PAR-MED-X ) were r and omly assigned to either the  intervention ( n=20 ) or control group ( n=18 ) . All participants completed pre- and post-testing assessment s immediately before and after the yoga program , respectively . RESULTS The yoga program participants ( M age=51.18 ( 10.33 ) ; 92 % female ) included primarily breast cancer survivors , on average 55.95 ( 54.39 ) months post-diagnosis . Significant differences between the intervention and the control group at post-intervention were seen only in psychosocial ( i.e. global quality of life , emotional function , and diarrhea ) variables ( all p 's < 0.05 ) . There were also trends for group differences , in the hypothesized directions , for the psychosocial variables of emotional irritability , gastrointestinal symptoms , cognitive disorganization , mood disturbance , tension , depression , and confusion ( all p 's < 0.10 ) . Finally , there were also significant improvements in both the program participants and the controls from pre- to post-intervention on a number of physical fitness variables . CONCLUSIONS These initial findings suggest that yoga has significant potential and should be further explored as a beneficial physical activity option for cancer survivors . Future research might attempt to include a broader range of participants ( e.g. other types of cancer diagnoses , male subjects ) , a larger sample size , and a longer program duration in an RCT OBJECTIVE Oral cancer elicits considerable distress in both the pre and post-treatment periods . This paper details the development , validation and pilot-testing of a psychoeducational intervention for oral cancer patients . METHOD An educational booklet covering information about oral cancer and its treatment and effective coping strategies was developed by a multi-disciplinary team . It was evaluated by patient focus groups and content/educational experts , delivered to subjects in pre and post-operative presentations by a health educator , and pilot-tested in a r and omized controlled trial versus st and ard care . RESULTS Pilot data from 19 subjects ( 10 psychoeducation , nine st and ard care )  indicates that the intervention is feasible and highly acceptable . At follow-up the intervention group showed a gain in knowledge , less body image disturbance , lower anxiety and a trend toward higher wellbeing . CONCLUSION This program , which is currently being evaluated in a larger RCT with extended follow-up , should prove useful in reducing the psychosocial burden of oral cancer and its treatment 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 BACKGROUND Major depressive disorder severely impairs the quality of life of patients with medical disorders such as cancer , but evidence to guide its management is scarce . We aim ed to assess the efficacy and cost of a nurse-delivered complex intervention that was design ed to treat major depressive disorder in patients who have cancer . METHODS We did a r and omised trial in a regional cancer centre in Scotl and , UK . 200 out patients who had cancer with a prognosis of greater than 6 months and major depressive disorder ( identified by screening ) were eligible and agreed to take part . Their mean age was 56.6 ( SD 11.9 ) years , and 141 ( 71 % ) were women . We r and omly assigned 99 of these participants to usual care , and 101 to usual care plus the intervention , with minimisation for sex , age , diagnosis , and extent of disease . The intervention was delivered by a cancer nurse at the centre over an average of seven sessions . The primary outcome was the difference in mean score on the self-reported Symptom Checklist-20 depression scale ( range 0 to 4 ) at 3 months after r and omisation . Analysis was by intention to treat . This trial is registered as IS RCT N84767225 . FINDINGS Primary outcome data were missing for four patients . For 196 patients for whom we had data at 3 months , the adjusted difference in mean Symptom Checklist-20 depression score , between those who received the intervention and those who did not , was 0.34 ( 95 % CI 0.13 - 0.55 ) . This treatment effect was sustained at 6 and 12 months . The intervention also improved anxiety and fatigue but not pain or physical functioning . It cost an additional pound sterling 5278 ( US$ 10 556 ) per quality -adjusted life-year gained . INTERPRETATION The intervention-Depression Care for People with Cancer-offers a model for the management of major depressive disorder in patients with cancer and other medical disorders who are attending specialist medical services that is feasible , acceptable , and potentially cost effective The potential benefits of health-related quality of life ( HRQL ) assessment in oncology clinical practice include better detection of problems , enhanced disease and treatment monitoring and improved care . However , few empirical studies have investigated the effects of incorporating such assessment s into routine clinical care . Recent r and omized studies have reported improved detection of and communication about patients ' concerns , but few have found effects on patient HRQL or satisfaction . This study examined whether offering interpretive assistance of HRQL results would improve these patient outcomes . Two hundred and thirteen participants with metastatic breast , lung or colorectal cancer were r and omly assigned to one of three conditions : usual care ; HRQL assessment or HRQL assessment followed by a structured interview and discussion . Interviews about patients ' assessment responses were conducted by a research nurse , who then presented HRQL information to the treating nurse . HRQL and treatment satisfaction outcomes were assessed at 3 and 6 months . No significant differences were found between study conditions in HRQL or satisfaction . Results suggest that routine HRQL assessment , even with description of results , is insufficient to improve patient HRQL and satisfaction . It is suggested that positive effects may require supplementing assessment results with specific suggestions for clinical management changes BACKGROUND We conducted a r and omised , controlled trial of cognitive-existential group therapy ( CEGT ) for women with early stage breast cancer receiving adjuvant chemotherapy with the aim of improving mood and mental attitude to cancer . METHODS Women were r and omised to 20 sessions of weekly group therapy plus 3 relaxation classes or to a control arm receiving 3 relaxation classes . Assessment s , independently done at baseline , 6 and 12 months , included a structured psychiatric interview and vali date d question naires covering mood , attitudes to cancer , family relationships , and satisfaction with therapy . RESULTS Three hundred and three of 491 ( 62 % ) eligible patients participated over 3 years .  Distress was 
    Output:
    