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: Abstract We examine the efficacy of conventional cognitive behavioral therapy ( CCBT ) versus religiously integrated CBT ( RCBT ) in persons with major depression and chronic medical illness . Participants were r and omized to either CCBT ( n = 67 ) or RCBT ( n = 65 ) . The intervention in both groups consisted of ten 50-minute sessions delivered remotely during 12 weeks ( 94 % by telephone ) . Adherence to treatment was similar , except in more religious participants in whom adherence to RCBT was slightly greater ( 85.7 % vs. 65.9 % , p = 0.10 ) . The intention-to-treat analysis at 12 weeks indicated no significant difference in outcome between the two groups ( B = 0.33 ; SE , 1.80 ; p = 0.86 ) . Response rates and remission rates were also similar . Overall religiosity interacted with treatment group ( B = −0.10 ; SE , 0.05 ; p = 0.048 ) , suggesting that RCBT was slightly more efficacious in the more religious participants . These preliminary findings suggest that CCBT and RCBT are equivalent treatments of  major depression in persons with chronic medical illness .  Efficacy , as well as adherence , may be affected by client religiosity OBJECTIVE Recovery-oriented care for patients with schizophrenia involves consideration of cultural issues , such as religion and spirituality . However , there is evidence that psychiatrists rarely address such topics . This study examined acceptance of a spiritual assessment  by patients and clinicians  , suggestions for treatment that arose from the assessment , and patient outcomes --in terms of treatment compliance and satisfaction with care ( as measured by treatment alliance ) . METHODS Out patients with psychosis were r and omly assigned to two groups : an  intervention group that received traditional treatment and a religious and spiritual assessment ( N=40 ) and a control group that received only traditional treatment ( N=38 ) . Eight psychiatrists were trained to administer the assessment to their established and stable patients . After each administration , the psychiatrist attended a supervision session with a psychiatrist and a psychologist of religion . Baseline and three-month data were collected . RESULTS The spiritual assessment  was well accepted by patients . During supervision , psychiatrists reported potential clinical uses for the assessment information for 67 % of patients . No between-group differences in medication adherence and satisfaction with care were found at three months , although patients in the intervention group had significantly better appointment attendance during the follow-up period . Their interest in discussing religion and spirituality with their psychiatrists remained high . The process was not as well accepted by psychiatrists . CONCLUSIONS  Spiritual assessment  can raise important clinical issues in the treatment of patients with chronic schizophrenia . Cultural factors , such as religion and spirituality , should be considered early in clinical training , because many clinicians are not at ease addressing such topics with patients A continuing challenge in weight loss treatment is attaining maintenance of weight loss . The goal of this study was to develop a counseling method that would assist African American breast cancer survivors with weight loss maintenance . In this pilot study , 31 obese breast cancer survivors were recruited .  Individualized , dietitian-led counseling by telephone and free Weight Watchers coupons were provided to all participants for 18 months . At the 6-month time point , women were r and omized to receive spirituality counseling or not in addition to the st and ard program . The spirituality counseling was delivered via telephone using an 8-step framework . Subjects were asked to utilize  daily meditation or prayer , daily readings  , and the recording of thoughts in a journal . Mean weight loss from baseline to 6 months was a modest 2.0 % of baseline weight . From 6 to 18 months , there was no further weight change in the spirituality arm and a gain of 0.7 % in the dietitian-only arm . Despite little effect on weight loss , it did appear that spirituality counseling positively affected spiritual well-being ( FACIT-Sp ) scores and dietary quality . The spirituality counseling framework therefore may be further refined and useful for other health promotion studies with African American population Overwhelming evidence shows the quality of reporting of r and omised controlled trials ( RCTs ) is not optimal . Without transparent reporting , readers can not judge the reliability and validity of trial findings nor extract information for systematic review s. Recent method ological analyses indicate that inadequate reporting and design are associated with biased estimates of treatment effects . Such systematic error is seriously damaging to RCTs , which are considered the gold st and ard for evaluating interventions because of their ability to minimise or avoid bias . A group of scientists and editors developed the CONSORT ( Consoli date d St and ards of Reporting Trials ) statement to improve the quality of reporting of RCTs . It was first published in 1996 and up date d in 2001 . The statement consists of a checklist and flow diagram that authors can use for reporting an RCT . Many leading medical journals and major international editorial groups have endorsed the CONSORT statement . The statement facilitates critical appraisal and interpretation of RCTs . During the 2001 CONSORT revision , it became clear that explanation and elaboration of the principles underlying the CONSORT statement would help investigators and others to write or appraise trial reports . A CONSORT explanation and elaboration article was published in 2001 alongside the 2001 version of the CONSORT statement . After an expert meeting in January 2007 , the CONSORT statement has been further revised and is published as the CONSORT 2010 Statement . This up date improves the wording and clarity of the previous checklist and incorporates recommendations related to topics that have only recently received recognition , such as selective outcome reporting bias . This explanatory and elaboration document-intended to enhance the use , underst and ing , and dissemination of the CONSORT statement-has also been extensively revised . It presents the meaning and rationale for each new and up date d checklist item providing examples of good reporting and , where possible , references to relevant empirical studies . Several examples of flow diagrams are included . The CONSORT 2010 Statement , this revised explanatory and elaboration document , and the associated website ( www.consort-statement.org ) should be helpful re sources to improve reporting of r and omised trials In order to examine mindfulness as an intervention for pain , 107 migraineurs , predominantly college students , were r and omly assigned to brief training in st and ardized mindfulness , spiritualized mindfulness , and simple relaxation instructions . After 2 weeks of daily practice , participants completed the cold-pressor task while practicing their assigned technique , and their experience of the task was assessed . Among the 74 study -completers , st and ardized mindfulness led to significantly reduced pain-related stress relative to simple relaxation , providing modest support for the utility of mindfulness in pain management . Pain-related outcomes in the spiritualized mindfulness condition were similar to those of st and ardized mindfulness , though spirituality did appear to enhance mindful awareness PURPOSE Spiritual well-being and sense of meaning are important concerns for clinicians who care for patients with cancer . We developed Individual Meaning-Centered Psychotherapy ( IMCP ) to address the need for brief interventions targeting spiritual well-being and meaning for patients with advanced cancer . PATIENTS AND METHODS Patients with stage III or IV cancer ( N = 120 ) were r and omly assigned to seven sessions of either IMCP or therapeutic massage ( TM ) . Patients were assessed before and after completing the intervention and 2 months postintervention . Primary outcome measures assessed spiritual well-being and quality of life ; secondary outcomes included anxiety , depression , hopelessness , symptom burden , and symptom-related distress . RESULTS Of the 120 participants r and omly assigned , 78 ( 65 % ) completed the post-treatment assessment and 67 ( 56 % ) completed the 2-month follow-up . At the post-treatment assessment , IMCP participants demonstrated significantly greater improvement than the control condition for the primary outcomes of spiritual well-being ( b = 0.39 ; P < .001 , including both components of spiritual well-being ( sense of meaning : b = 0.34 ; P = .003 and faith : b = 0.42 ; P = .03 ) , and quality of life ( b = 0.76 ; P = .013 ) . Significantly greater improvements for IMCP patients were also observed for the secondary outcomes of symptom burden ( b = -6.56 ; P < .001 ) and symptom-related distress ( b = -0.47 ; P < .001 ) but not for anxiety , depression , or hopelessness . At the 2-month follow-up assessment , the improvements observed for the IMCP group were no longer significantly greater than those observed for the TM group . CONCLUSION IMCP has clear short-term benefits for spiritual suffering and quality of life in patients with advanced cancer . Clinicians working with patients who have advanced cancer should consider IMCP as an approach to enhance quality of life and spiritual well-being We examined the efficacy of a psycho-spiritual intervention of mantram repetition -- a word or phrase with spiritual associations repeated silently throughout the day -- on psychological distress ( intrusive thoughts , stress , anxiety , anger , depression ) , quality of life enjoyment and satisfaction , and existential spiritual well-being  in HIV-infected adults . Using a 2-group by 4-time repeated measures design , 93 participants were r and omly assigned to mantram ( n = 46 ) or attention control group ( n = 47 ) . Over time , the mantram group improved significantly more than the control group in reducing trait-anger and increasing spiritual faith and spiritual connectedness . Actual mantram practice measured by wrist counters was inversely associated with non-HIV related intrusive thoughts and positively associated with quality of life , total existential spiritual well-being , meaning/peace , and spiritual faith . Intent-to-treat findings suggest that a mantram group intervention and actual mantram practice each make unique contributions for managing psychological distress and enhancing existential spiritual well-being in adults living with HIV/AIDS Adequate reporting of r and omized , controlled trials ( RCTs ) is necessary to allow accurate critical appraisal of the validity and applicability of the results . The CONSORT ( Consoli date d St and ards of Reporting Trials ) Statement , a 22-item checklist and flow diagram , is intended to address this problem by improving the reporting of RCTs . However , some specific issues that apply to trials of nonpharmacologic treatments ( for example , surgery , technical interventions , devices , rehabilitation , psychotherapy , and behavioral intervention ) are not specifically addressed in the CONSORT Statement . Furthermore , considerable evidence suggests that the reporting of nonpharmacologic trials still needs improvement . Therefore , the CONSORT group developed an extension of the CONSORT Statement for trials assessing nonpharmacologic treatments . A consensus meeting of 33 experts was organized in Paris , France , in February 2006 , to develop an extension of the CONSORT Statement for trials of nonpharmacologic treatments . The participants extended 11 items from the CONSORT Statement , added 1 item , and developed a modified flow diagram . To allow adequate underst and ing and implementation of the CONSORT extension , the CONSORT group developed this elaboration and explanation document from a review of the literature to provide examples of adequate reporting . This extension , in conjunction with the main CONSORT Statement and other CONSORT extensions , should help to improve the reporting of RCTs performed in this field Nurses have long recognized the importance of spiritual care in nursing practice as promoting the integration of meaning and purpose in life . More recently , both the American Nurses Association incorporates spiritual care in the Scope and St and ards of Nursing Practice and the American Association of Colleges of Nursing has integrated spiritual care in the Essentials of Baccalaureate Education . However , research suggests that nurses do not know how to provide spiritual care . This study developed and tested a spiritual care pedagogy . In phase I , research ers design ed a spiritual care educational and reflective program based on the Burkhart/Hogan theory of spiritual care in nursing practice , incorporating face-to-face and on-line components . In phase 2 , the effectiveness of this program was measured in a pre-post test , r and omized controlled trial with senior nursing students during their capstone clinical immersion course ( n=59 ) . Findings revealed a statistically significant increase in  students ' perceived ability in providing spiritual care , particularly in complex family clinical situations . Findings also indicated a significant increase in the student 's use of reflective practice s , which students found to help support them during stressful times . This study translates nursing theory and research into a successful pedagogy Colorectal cancer screening , while effective for reducing mortality , remains underutilized particularly among underserved population s such as African Americans . The present study evaluated a spiritually based approach to increasing Health Belief Model – based pre-screening outcomes in a Community Health Advisor – led intervention conducted in African American churches . Sixteen urban churches were r and omized to receive either the spiritually based intervention or a nonspiritual comparison of the same structure and core colorectal cancer content . Trained Community Health Advisors led a series of two educational sessions on colorectal cancer early detection . The educational sessions were delivered over a 1-month period . Participants ( N = 316 ) completed a baseline survey at enrollment and a follow-up survey one month after the first session . Both interventions result ed in significant pre/post increases in knowledge , perceived benefits of screening , and decreases in perceived barriers to screening . Among women , the spiritually based intervention result ed in significantly greater increases in perceived benefits of screening relative to the nonspiritual comparison . This finding was marginal in the sample as a whole . In addition , perceived benefits to screening were associated with behavioral intention for screening . It is concluded that in this population , the spiritually based was generally as effective as the nonspiritual ( secular ) communication The purpose of this study was to compare the communication effectiveness of a spiritually based approach to breast cancer early detection education with a secular approach , among African American women , by conducting a cognitive response analysis . A total of  
    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: Abstract We examine the efficacy of conventional cognitive behavioral therapy ( CCBT ) versus religiously integrated CBT ( RCBT ) in persons with major depression and chronic medical illness . Participants were r and omized to either CCBT ( n = 67 ) or RCBT ( n = 65 ) . The intervention in both groups consisted of ten 50-minute sessions delivered remotely during 12 weeks ( 94 % by telephone ) . Adherence to treatment was similar , except in more religious participants in whom adherence to RCBT was slightly greater ( 85.7 % vs. 65.9 % , p = 0.10 ) . The intention-to-treat analysis at 12 weeks indicated no significant difference in outcome between the two groups ( B = 0.33 ; SE , 1.80 ; p = 0.86 ) . Response rates and remission rates were also similar . Overall religiosity interacted with treatment group ( B = −0.10 ; SE , 0.05 ; p = 0.048 ) , suggesting that RCBT was slightly more efficacious in the more religious participants . These preliminary findings suggest that CCBT and RCBT are equivalent treatments of  major depression in persons with chronic medical illness .  Efficacy , as well as adherence , may be affected by client religiosity OBJECTIVE Recovery-oriented care for patients with schizophrenia involves consideration of cultural issues , such as religion and spirituality . However , there is evidence that psychiatrists rarely address such topics . This study examined acceptance of a spiritual assessment  by patients and clinicians  , suggestions for treatment that arose from the assessment , and patient outcomes --in terms of treatment compliance and satisfaction with care ( as measured by treatment alliance ) . METHODS Out patients with psychosis were r and omly assigned to two groups : an  intervention group that received traditional treatment and a religious and spiritual assessment ( N=40 ) and a control group that received only traditional treatment ( N=38 ) . Eight psychiatrists were trained to administer the assessment to their established and stable patients . After each administration , the psychiatrist attended a supervision session with a psychiatrist and a psychologist of religion . Baseline and three-month data were collected . RESULTS The spiritual assessment  was well accepted by patients . During supervision , psychiatrists reported potential clinical uses for the assessment information for 67 % of patients . No between-group differences in medication adherence and satisfaction with care were found at three months , although patients in the intervention group had significantly better appointment attendance during the follow-up period . Their interest in discussing religion and spirituality with their psychiatrists remained high . The process was not as well accepted by psychiatrists . CONCLUSIONS  Spiritual assessment  can raise important clinical issues in the treatment of patients with chronic schizophrenia . Cultural factors , such as religion and spirituality , should be considered early in clinical training , because many clinicians are not at ease addressing such topics with patients A continuing challenge in weight loss treatment is attaining maintenance of weight loss . The goal of this study was to develop a counseling method that would assist African American breast cancer survivors with weight loss maintenance . In this pilot study , 31 obese breast cancer survivors were recruited .  Individualized , dietitian-led counseling by telephone and free Weight Watchers coupons were provided to all participants for 18 months . At the 6-month time point , women were r and omized to receive spirituality counseling or not in addition to the st and ard program . The spirituality counseling was delivered via telephone using an 8-step framework . Subjects were asked to utilize  daily meditation or prayer , daily readings  , and the recording of thoughts in a journal . Mean weight loss from baseline to 6 months was a modest 2.0 % of baseline weight . From 6 to 18 months , there was no further weight change in the spirituality arm and a gain of 0.7 % in the dietitian-only arm . Despite little effect on weight loss , it did appear that spirituality counseling positively affected spiritual well-being ( FACIT-Sp ) scores and dietary quality . The spirituality counseling framework therefore may be further refined and useful for other health promotion studies with African American population Overwhelming evidence shows the quality of reporting of r and omised controlled trials ( RCTs ) is not optimal . Without transparent reporting , readers can not judge the reliability and validity of trial findings nor extract information for systematic review s. Recent method ological analyses indicate that inadequate reporting and design are associated with biased estimates of treatment effects . Such systematic error is seriously damaging to RCTs , which are considered the gold st and ard for evaluating interventions because of their ability to minimise or avoid bias . A group of scientists and editors developed the CONSORT ( Consoli date d St and ards of Reporting Trials ) statement to improve the quality of reporting of RCTs . It was first published in 1996 and up date d in 2001 . The statement consists of a checklist and flow diagram that authors can use for reporting an RCT . Many leading medical journals and major international editorial groups have endorsed the CONSORT statement . The statement facilitates critical appraisal and interpretation of RCTs . During the 2001 CONSORT revision , it became clear that explanation and elaboration of the principles underlying the CONSORT statement would help investigators and others to write or appraise trial reports . A CONSORT explanation and elaboration article was published in 2001 alongside the 2001 version of the CONSORT statement . After an expert meeting in January 2007 , the CONSORT statement has been further revised and is published as the CONSORT 2010 Statement . This up date improves the wording and clarity of the previous checklist and incorporates recommendations related to topics that have only recently received recognition , such as selective outcome reporting bias . This explanatory and elaboration document-intended to enhance the use , underst and ing , and dissemination of the CONSORT statement-has also been extensively revised . It presents the meaning and rationale for each new and up date d checklist item providing examples of good reporting and , where possible , references to relevant empirical studies . Several examples of flow diagrams are included . The CONSORT 2010 Statement , this revised explanatory and elaboration document , and the associated website ( www.consort-statement.org ) should be helpful re sources to improve reporting of r and omised trials In order to examine mindfulness as an intervention for pain , 107 migraineurs , predominantly college students , were r and omly assigned to brief training in st and ardized mindfulness , spiritualized mindfulness , and simple relaxation instructions . After 2 weeks of daily practice , participants completed the cold-pressor task while practicing their assigned technique , and their experience of the task was assessed . Among the 74 study -completers , st and ardized mindfulness led to significantly reduced pain-related stress relative to simple relaxation , providing modest support for the utility of mindfulness in pain management . Pain-related outcomes in the spiritualized mindfulness condition were similar to those of st and ardized mindfulness , though spirituality did appear to enhance mindful awareness PURPOSE Spiritual well-being and sense of meaning are important concerns for clinicians who care for patients with cancer . We developed Individual Meaning-Centered Psychotherapy ( IMCP ) to address the need for brief interventions targeting spiritual well-being and meaning for patients with advanced cancer . PATIENTS AND METHODS Patients with stage III or IV cancer ( N = 120 ) were r and omly assigned to seven sessions of either IMCP or therapeutic massage ( TM ) . Patients were assessed before and after completing the intervention and 2 months postintervention . Primary outcome measures assessed spiritual well-being and quality of life ; secondary outcomes included anxiety , depression , hopelessness , symptom burden , and symptom-related distress . RESULTS Of the 120 participants r and omly assigned , 78 ( 65 % ) completed the post-treatment assessment and 67 ( 56 % ) completed the 2-month follow-up . At the post-treatment assessment , IMCP participants demonstrated significantly greater improvement than the control condition for the primary outcomes of spiritual well-being ( b = 0.39 ; P < .001 , including both components of spiritual well-being ( sense of meaning : b = 0.34 ; P = .003 and faith : b = 0.42 ; P = .03 ) , and quality of life ( b = 0.76 ; P = .013 ) . Significantly greater improvements for IMCP patients were also observed for the secondary outcomes of symptom burden ( b = -6.56 ; P < .001 ) and symptom-related distress ( b = -0.47 ; P < .001 ) but not for anxiety , depression , or hopelessness . At the 2-month follow-up assessment , the improvements observed for the IMCP group were no longer significantly greater than those observed for the TM group . CONCLUSION IMCP has clear short-term benefits for spiritual suffering and quality of life in patients with advanced cancer . Clinicians working with patients who have advanced cancer should consider IMCP as an approach to enhance quality of life and spiritual well-being We examined the efficacy of a psycho-spiritual intervention of mantram repetition -- a word or phrase with spiritual associations repeated silently throughout the day -- on psychological distress ( intrusive thoughts , stress , anxiety , anger , depression ) , quality of life enjoyment and satisfaction , and existential spiritual well-being  in HIV-infected adults . Using a 2-group by 4-time repeated measures design , 93 participants were r and omly assigned to mantram ( n = 46 ) or attention control group ( n = 47 ) . Over time , the mantram group improved significantly more than the control group in reducing trait-anger and increasing spiritual faith and spiritual connectedness . Actual mantram practice measured by wrist counters was inversely associated with non-HIV related intrusive thoughts and positively associated with quality of life , total existential spiritual well-being , meaning/peace , and spiritual faith . Intent-to-treat findings suggest that a mantram group intervention and actual mantram practice each make unique contributions for managing psychological distress and enhancing existential spiritual well-being in adults living with HIV/AIDS Adequate reporting of r and omized , controlled trials ( RCTs ) is necessary to allow accurate critical appraisal of the validity and applicability of the results . The CONSORT ( Consoli date d St and ards of Reporting Trials ) Statement , a 22-item checklist and flow diagram , is intended to address this problem by improving the reporting of RCTs . However , some specific issues that apply to trials of nonpharmacologic treatments ( for example , surgery , technical interventions , devices , rehabilitation , psychotherapy , and behavioral intervention ) are not specifically addressed in the CONSORT Statement . Furthermore , considerable evidence suggests that the reporting of nonpharmacologic trials still needs improvement . Therefore , the CONSORT group developed an extension of the CONSORT Statement for trials assessing nonpharmacologic treatments . A consensus meeting of 33 experts was organized in Paris , France , in February 2006 , to develop an extension of the CONSORT Statement for trials of nonpharmacologic treatments . The participants extended 11 items from the CONSORT Statement , added 1 item , and developed a modified flow diagram . To allow adequate underst and ing and implementation of the CONSORT extension , the CONSORT group developed this elaboration and explanation document from a review of the literature to provide examples of adequate reporting . This extension , in conjunction with the main CONSORT Statement and other CONSORT extensions , should help to improve the reporting of RCTs performed in this field Nurses have long recognized the importance of spiritual care in nursing practice as promoting the integration of meaning and purpose in life . More recently , both the American Nurses Association incorporates spiritual care in the Scope and St and ards of Nursing Practice and the American Association of Colleges of Nursing has integrated spiritual care in the Essentials of Baccalaureate Education . However , research suggests that nurses do not know how to provide spiritual care . This study developed and tested a spiritual care pedagogy . In phase I , research ers design ed a spiritual care educational and reflective program based on the Burkhart/Hogan theory of spiritual care in nursing practice , incorporating face-to-face and on-line components . In phase 2 , the effectiveness of this program was measured in a pre-post test , r and omized controlled trial with senior nursing students during their capstone clinical immersion course ( n=59 ) . Findings revealed a statistically significant increase in  students ' perceived ability in providing spiritual care , particularly in complex family clinical situations . Findings also indicated a significant increase in the student 's use of reflective practice s , which students found to help support them during stressful times . This study translates nursing theory and research into a successful pedagogy Colorectal cancer screening , while effective for reducing mortality , remains underutilized particularly among underserved population s such as African Americans . The present study evaluated a spiritually based approach to increasing Health Belief Model – based pre-screening outcomes in a Community Health Advisor – led intervention conducted in African American churches . Sixteen urban churches were r and omized to receive either the spiritually based intervention or a nonspiritual comparison of the same structure and core colorectal cancer content . Trained Community Health Advisors led a series of two educational sessions on colorectal cancer early detection . The educational sessions were delivered over a 1-month period . Participants ( N = 316 ) completed a baseline survey at enrollment and a follow-up survey one month after the first session . Both interventions result ed in significant pre/post increases in knowledge , perceived benefits of screening , and decreases in perceived barriers to screening . Among women , the spiritually based intervention result ed in significantly greater increases in perceived benefits of screening relative to the nonspiritual comparison . This finding was marginal in the sample as a whole . In addition , perceived benefits to screening were associated with behavioral intention for screening . It is concluded that in this population , the spiritually based was generally as effective as the nonspiritual ( secular ) communication The purpose of this study was to compare the communication effectiveness of a spiritually based approach to breast cancer early detection education with a secular approach , among African American women , by conducting a cognitive response analysis . A total of  
    Output:
    