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: Given that retention rates for weight-loss trials have not significantly improved in the past 20 years , identifying effective techniques to enhance retention is critical . This paper describes a conceptual and practical advance that may have improved retention in a behavioral weight-loss trial-the novel application of motivational interviewing techniques to diffuse ambivalence during interactive group-based orientation sessions prior to r and omization . These orientation sessions addressed ambivalence about making eating and exercise behavior changes , ambivalence about joining a r and omized controlled trial , and unrealistic weight-loss expectations . During these sessions , overweight and obese men and women learned about the health benefits of modest weight loss as well as trial design , the importance of a control condition , r and om assignment and the impact of dropouts . Participants were then divided into groups of three or four , and asked to generate two pros and two cons of being assigned to a control condition and an active condition . Participants shared their pros and cons with the larger group , while the investigator asked open-ended questions , engaged in reflective listening and avoided taking a ' pro-change ' position . Retention was high , with 96 % of the participants ( N = 162 ) completing 18-month clinic visits PURPOSE By means of a r and omized double-blind study , the effect of providing taped initial consultations on cancer patients '  satisfaction , recall , and quality of life was investigated . PATIENTS AND METHODS Consecutive cancer patients referred to either the gynecology or medical oncology outpatient clinic were eligible .  Initial consultations were audiotaped . Patients were either provided with the tape ( experimental group ) or not ( control group ) . Baseline variables included sociodemographics , preferences for information , coping styles , and clinical characteristics . Follow-up ( after 1 week and 3 months ) variables included attitudes toward the intervention , satisfaction , recall , and quality of life . Assessment s took place through mailed question naires and telephone interviews . RESULTS Two hundred one patients were included ( response , 71 % ) , 105 in the experimental group and 96 in the control group . Most patients ( 75 % ) listened to the tape , the majority of which ( 73 % ) listened with others . Almost all patients , both in the experimental group ( 96 % ) and control group ( 98 % ) were positive about the intervention . Expectations were confirmed ; patients provided with the tape were more satisfied ( P < .05 ) and recalled more information ( P < .01 ) than patients without the tape . The intervention did not have an effect on quality of life . An interaction effect was found between the intervention and patients ' age on satisfaction with the taped consultation ( P < .01 ) and recall of diagnostic information ( P < .01 ) ; access to tapes seems more helpful in enhancing satisfaction in younger patients and recall of diagnostic information in older patients . CONCLUSION Cancer patients and their families value the taped initial consultation . This intervention enhances their satisfaction and improves their recall of information . Tapes seem more helpful in enhancing satisfaction in younger patients and recall of diagnostic information in older patients PURPOSE The aims of this pilot study were the following : 1 ) to examine patterns of adherence to a brisk walking program in women receiving adjuvant chemotherapy or radiation therapy for newly diagnosed breast cancer using a prospect i ve , r and omized , controlled experimental design ; 2 ) to examine the influence of disease symptoms and treatment side effects on exercise levels ; and 3 ) to suggest methods that may improve future clinical trials of moderate-intensity exercise in similar population s. DESCRIPTION OF STUDY Fifty-two patients with newly diagnosed breast cancer were r and omly assigned to one of two treatment arms : usual care or usual care plus exercise . Those assigned to the exercise group received a st and ardized , self-administered , home-based brisk walking intervention in addition to usual care . Each day subjects completed self-report diary forms that elicited information about activity levels , and the occurrence of symptoms and side effects during cancer treatment . RESULTS Analyses of self-reported daily activity levels revealed a diffusion of treatment effect . Fifty percent of the usual-care group reported maintaining or increasing their physical activity to a moderate-intensity level , while 33 % of the exercise group did not exercise at the prescribed levels . Analyses of self-reported disease symptoms and treatment side effects did not reveal clinical ly meaningful differences between the two groups . CLINICAL IMPLICATION S The results of this study suggest that women who exercised regularly before receiving a breast cancer diagnosis attempted to maintain their exercise programs . Women who lead sedentary lifestyles may benefit from a structured exercise program that includes information and support related to exercise adherence strategies 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 In a prior study [ Festinger , D.S. , Marlowe , D.B. , Croft , J.R. , Dugosh , K.L. , Mastro , N.K. , Lee , P.A. , DeMatteo , D.S. , Patapis , N.S. , 2005 . Do research payments precipitate drug use or coerce participation ? Drug Alcohol Depend . 78 ( 3 ) 275 - 281 ] we found that neither the mode ( cash vs. gift card ) nor magnitude ( $ 10 , $ 40 , or $ 70 ) of research follow-up payments increased rates of new drug use or perceptions of coercion . However , higher payments and payments in cash were associated with better follow-up attendance , reduced tracking efforts , and improved participant satisfaction with the study . The present study extended those findings to higher payment magnitudes . Participants from an urban outpatient substance abuse treatment program were r and omly assigned to receive $ 70 , $ 100 , $ 130 , or $ 160 in either cash or a gift card for completing a follow-up assessment at 6 months post-admission ( n congruent with 50 per cell ) . Apart from the payment incentives , all participants received a st and ardized , minimal platform of follow-up efforts . Findings revealed that neither the magnitude nor mode of payment had a significant effect on new drug use or perceived coercion . Consistent with our previous findings , higher payments and cash payments result ed in significantly higher follow-up rates and fewer tracking calls . In addition participants receiving cash vs. gift cards were more likely to use their payments for essential , non-luxury purchases . Follow-up rates for participants receiving cash payments of $ 100 , $ 130 , and $ 160 approached or exceeded the FDA required minimum of 70 % for studies to be considered in evaluations of new medications . This suggests that the use of higher magnitude payments and cash payments may be effective strategies for obtaining more representative follow-up sample s without increasing new drug use or perceptions of coercion This paper describes a r and omized clinical trial investigating a stress management program for women with breast cancer , which inadvertently turned quasi-experimental . Due to logistical considerations , group assignment was disclosed to participants ( n = 63 ) prior to baseline assessment . Analyses of baseline measures unexpectedly revealed statistically significant differences between groups on psychological functioning . We suggest that what appears to be failed r and omization may in fact point toward an important phenomenon which we have termed premature disclosure effect ( PDE ) . A hierarchical regression model , developed to help explain the PDE , accounted for 47 % of the variance . The findings indicate the importance of considering participant belief , preferences , and attributes when design ing research protocol s and interventions . Potential implication s of PDE for clinical research in behavioral medicine are discussed and specific statistical method ologies suggested In this study , we examined correlates of adherence and contamination in a r and omized controlled trial ( RCT ) of exercise in cancer survivors using the theory of planned behavior and the Five Factor Model of personality ( FFM ) . We r and omly assigned cancer survivors in group psychotherapy classes to either a waiting-list control group ( n = 45 ) or a home-based , moderate intensity exercise program ( n = 51 ) . At baseline , participants completed  measures  of the theory of planned behavior , the FFM , past exercise , physical fitness , medical variables , and demographics . We then monitored exercise over a 10-week period by weekly self-reports . Hierarchical multiple regression analyses indicated that the independent predictors of overall RCT exercise across both conditions were past exercise ( β = .36 , p > .001 ) , assignment to experimental condition ( β = .34 , p > .001 ) , sex ( β = .30 , p > .001 ) , and intention ( β = .14 , p > .10 ) . For exercise adherence in the exercise condition , the independent predictors were sex ( β = .38 , p > .01 ) , extraversion ( β = .30 , p > .05 ) , normative beliefs ( β = -.27 , p > .05 ) , and perceived behavioral control ( β = .23 , p > .10 ) . Finally , the independent predictors of exercise contamination in the control condition were past exercise ( β = .70 , p > .001 ) , sex ( β = .20 , p > .05 ) , and intention ( β = .17 , p > .10 ) . We conclude that the correlates of exercise adherence and contamination differ in kind as well as in degree . Explanations for these findings and practical implication s for conducting exercise RCTs in this population are offered 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 Purpose : Cohort studies investigating genes , environment , and lifestyle require large study population s. To recruit and retain participants , it is important to underst and the relative significance of influences on people 's motivation to participate . To this end , 4659 Americans were surveyed about support for and willingness to participate in a proposed large cohort study . Methods : An  online survey of US adults was conducted between December 2007 and January 2008 . To measure the influence of study burden , compensation and receipt of individual research results  on willingness to participate , respondents were r and omized to one of eight different study scenarios . Results : Most respondents ( 84 % ) supported the study , and 60 % would participate . Returning research results ( odds ratio = 1.6 , 95 % confidence interval 1.3–1.8 ) and increasing compensation from $ 50 to $ 200 ( odds ratio = 1.5 , 95 % confidence interval 1.2–1.7 ) were associated with increased willingness to participate . Decreasing study burden was less important ( odds ratio = 1.2 , 95 % confidence interval 1.0–1.4 ) . Three in four respondents would be less likely to participate without the return of research results . Support and willingness varied little among demographic groups ; variation in influences of the three factors on willingness was observed . Conclusion : Widespread support exists in the general public for a large national cohort study . Providing individual research results is a strong motivation to participate ; compensating participants $ 200 may increase participation a similar amount . Incentives , recruitment , and return of results could be tailored to demographics groups ' interests PURPOSE / OBJECTIVES To find the most effective methods of providing social support for women diagnosed with breast cancer by testing the effectiveness of a telephone social support and education intervention to promote emotional and interpersonal adaptation to breast cancer . DESIGN Multisite , two-group experimental study with repeated measures . SETTING Arkansas and New Jersey . SAMPLE The Arkansas sample consisted of 106 women who entered the study two to four weeks postsurgery for nonmetastatic breast cancer and were r and omly assigned to an experimental or control group . The comparison group consisted of 91 women from New Jersey who had participated in a previously completed study that used the same interventions and found that telephone support result ed in more positive , statistically significant adaptation to the disease . METHODS The experimental group received 13 months of telephone social support and education . Both groups received educational material s via a mailed re source kit . The Profile of Mood States ; Visual Anal 
    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: Given that retention rates for weight-loss trials have not significantly improved in the past 20 years , identifying effective techniques to enhance retention is critical . This paper describes a conceptual and practical advance that may have improved retention in a behavioral weight-loss trial-the novel application of motivational interviewing techniques to diffuse ambivalence during interactive group-based orientation sessions prior to r and omization . These orientation sessions addressed ambivalence about making eating and exercise behavior changes , ambivalence about joining a r and omized controlled trial , and unrealistic weight-loss expectations . During these sessions , overweight and obese men and women learned about the health benefits of modest weight loss as well as trial design , the importance of a control condition , r and om assignment and the impact of dropouts . Participants were then divided into groups of three or four , and asked to generate two pros and two cons of being assigned to a control condition and an active condition . Participants shared their pros and cons with the larger group , while the investigator asked open-ended questions , engaged in reflective listening and avoided taking a ' pro-change ' position . Retention was high , with 96 % of the participants ( N = 162 ) completing 18-month clinic visits PURPOSE By means of a r and omized double-blind study , the effect of providing taped initial consultations on cancer patients '  satisfaction , recall , and quality of life was investigated . PATIENTS AND METHODS Consecutive cancer patients referred to either the gynecology or medical oncology outpatient clinic were eligible .  Initial consultations were audiotaped . Patients were either provided with the tape ( experimental group ) or not ( control group ) . Baseline variables included sociodemographics , preferences for information , coping styles , and clinical characteristics . Follow-up ( after 1 week and 3 months ) variables included attitudes toward the intervention , satisfaction , recall , and quality of life . Assessment s took place through mailed question naires and telephone interviews . RESULTS Two hundred one patients were included ( response , 71 % ) , 105 in the experimental group and 96 in the control group . Most patients ( 75 % ) listened to the tape , the majority of which ( 73 % ) listened with others . Almost all patients , both in the experimental group ( 96 % ) and control group ( 98 % ) were positive about the intervention . Expectations were confirmed ; patients provided with the tape were more satisfied ( P < .05 ) and recalled more information ( P < .01 ) than patients without the tape . The intervention did not have an effect on quality of life . An interaction effect was found between the intervention and patients ' age on satisfaction with the taped consultation ( P < .01 ) and recall of diagnostic information ( P < .01 ) ; access to tapes seems more helpful in enhancing satisfaction in younger patients and recall of diagnostic information in older patients . CONCLUSION Cancer patients and their families value the taped initial consultation . This intervention enhances their satisfaction and improves their recall of information . Tapes seem more helpful in enhancing satisfaction in younger patients and recall of diagnostic information in older patients PURPOSE The aims of this pilot study were the following : 1 ) to examine patterns of adherence to a brisk walking program in women receiving adjuvant chemotherapy or radiation therapy for newly diagnosed breast cancer using a prospect i ve , r and omized , controlled experimental design ; 2 ) to examine the influence of disease symptoms and treatment side effects on exercise levels ; and 3 ) to suggest methods that may improve future clinical trials of moderate-intensity exercise in similar population s. DESCRIPTION OF STUDY Fifty-two patients with newly diagnosed breast cancer were r and omly assigned to one of two treatment arms : usual care or usual care plus exercise . Those assigned to the exercise group received a st and ardized , self-administered , home-based brisk walking intervention in addition to usual care . Each day subjects completed self-report diary forms that elicited information about activity levels , and the occurrence of symptoms and side effects during cancer treatment . RESULTS Analyses of self-reported daily activity levels revealed a diffusion of treatment effect . Fifty percent of the usual-care group reported maintaining or increasing their physical activity to a moderate-intensity level , while 33 % of the exercise group did not exercise at the prescribed levels . Analyses of self-reported disease symptoms and treatment side effects did not reveal clinical ly meaningful differences between the two groups . CLINICAL IMPLICATION S The results of this study suggest that women who exercised regularly before receiving a breast cancer diagnosis attempted to maintain their exercise programs . Women who lead sedentary lifestyles may benefit from a structured exercise program that includes information and support related to exercise adherence strategies 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 In a prior study [ Festinger , D.S. , Marlowe , D.B. , Croft , J.R. , Dugosh , K.L. , Mastro , N.K. , Lee , P.A. , DeMatteo , D.S. , Patapis , N.S. , 2005 . Do research payments precipitate drug use or coerce participation ? Drug Alcohol Depend . 78 ( 3 ) 275 - 281 ] we found that neither the mode ( cash vs. gift card ) nor magnitude ( $ 10 , $ 40 , or $ 70 ) of research follow-up payments increased rates of new drug use or perceptions of coercion . However , higher payments and payments in cash were associated with better follow-up attendance , reduced tracking efforts , and improved participant satisfaction with the study . The present study extended those findings to higher payment magnitudes . Participants from an urban outpatient substance abuse treatment program were r and omly assigned to receive $ 70 , $ 100 , $ 130 , or $ 160 in either cash or a gift card for completing a follow-up assessment at 6 months post-admission ( n congruent with 50 per cell ) . Apart from the payment incentives , all participants received a st and ardized , minimal platform of follow-up efforts . Findings revealed that neither the magnitude nor mode of payment had a significant effect on new drug use or perceived coercion . Consistent with our previous findings , higher payments and cash payments result ed in significantly higher follow-up rates and fewer tracking calls . In addition participants receiving cash vs. gift cards were more likely to use their payments for essential , non-luxury purchases . Follow-up rates for participants receiving cash payments of $ 100 , $ 130 , and $ 160 approached or exceeded the FDA required minimum of 70 % for studies to be considered in evaluations of new medications . This suggests that the use of higher magnitude payments and cash payments may be effective strategies for obtaining more representative follow-up sample s without increasing new drug use or perceptions of coercion This paper describes a r and omized clinical trial investigating a stress management program for women with breast cancer , which inadvertently turned quasi-experimental . Due to logistical considerations , group assignment was disclosed to participants ( n = 63 ) prior to baseline assessment . Analyses of baseline measures unexpectedly revealed statistically significant differences between groups on psychological functioning . We suggest that what appears to be failed r and omization may in fact point toward an important phenomenon which we have termed premature disclosure effect ( PDE ) . A hierarchical regression model , developed to help explain the PDE , accounted for 47 % of the variance . The findings indicate the importance of considering participant belief , preferences , and attributes when design ing research protocol s and interventions . Potential implication s of PDE for clinical research in behavioral medicine are discussed and specific statistical method ologies suggested In this study , we examined correlates of adherence and contamination in a r and omized controlled trial ( RCT ) of exercise in cancer survivors using the theory of planned behavior and the Five Factor Model of personality ( FFM ) . We r and omly assigned cancer survivors in group psychotherapy classes to either a waiting-list control group ( n = 45 ) or a home-based , moderate intensity exercise program ( n = 51 ) . At baseline , participants completed  measures  of the theory of planned behavior , the FFM , past exercise , physical fitness , medical variables , and demographics . We then monitored exercise over a 10-week period by weekly self-reports . Hierarchical multiple regression analyses indicated that the independent predictors of overall RCT exercise across both conditions were past exercise ( β = .36 , p > .001 ) , assignment to experimental condition ( β = .34 , p > .001 ) , sex ( β = .30 , p > .001 ) , and intention ( β = .14 , p > .10 ) . For exercise adherence in the exercise condition , the independent predictors were sex ( β = .38 , p > .01 ) , extraversion ( β = .30 , p > .05 ) , normative beliefs ( β = -.27 , p > .05 ) , and perceived behavioral control ( β = .23 , p > .10 ) . Finally , the independent predictors of exercise contamination in the control condition were past exercise ( β = .70 , p > .001 ) , sex ( β = .20 , p > .05 ) , and intention ( β = .17 , p > .10 ) . We conclude that the correlates of exercise adherence and contamination differ in kind as well as in degree . Explanations for these findings and practical implication s for conducting exercise RCTs in this population are offered 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 Purpose : Cohort studies investigating genes , environment , and lifestyle require large study population s. To recruit and retain participants , it is important to underst and the relative significance of influences on people 's motivation to participate . To this end , 4659 Americans were surveyed about support for and willingness to participate in a proposed large cohort study . Methods : An  online survey of US adults was conducted between December 2007 and January 2008 . To measure the influence of study burden , compensation and receipt of individual research results  on willingness to participate , respondents were r and omized to one of eight different study scenarios . Results : Most respondents ( 84 % ) supported the study , and 60 % would participate . Returning research results ( odds ratio = 1.6 , 95 % confidence interval 1.3–1.8 ) and increasing compensation from $ 50 to $ 200 ( odds ratio = 1.5 , 95 % confidence interval 1.2–1.7 ) were associated with increased willingness to participate . Decreasing study burden was less important ( odds ratio = 1.2 , 95 % confidence interval 1.0–1.4 ) . Three in four respondents would be less likely to participate without the return of research results . Support and willingness varied little among demographic groups ; variation in influences of the three factors on willingness was observed . Conclusion : Widespread support exists in the general public for a large national cohort study . Providing individual research results is a strong motivation to participate ; compensating participants $ 200 may increase participation a similar amount . Incentives , recruitment , and return of results could be tailored to demographics groups ' interests PURPOSE / OBJECTIVES To find the most effective methods of providing social support for women diagnosed with breast cancer by testing the effectiveness of a telephone social support and education intervention to promote emotional and interpersonal adaptation to breast cancer . DESIGN Multisite , two-group experimental study with repeated measures . SETTING Arkansas and New Jersey . SAMPLE The Arkansas sample consisted of 106 women who entered the study two to four weeks postsurgery for nonmetastatic breast cancer and were r and omly assigned to an experimental or control group . The comparison group consisted of 91 women from New Jersey who had participated in a previously completed study that used the same interventions and found that telephone support result ed in more positive , statistically significant adaptation to the disease . METHODS The experimental group received 13 months of telephone social support and education . Both groups received educational material s via a mailed re source kit . The Profile of Mood States ; Visual Anal 
    Output:
    