***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background The North-Eastern part of Sri Lanka had already been affected by civil war when the 2004 Tsunami wave hit the region , leading to high rates of posttraumatic stress disorder ( PTSD ) in children . In the acute aftermath of the Tsunami we tested the efficacy of two pragmatic short-term interventions when applied by trained local counselors . Methods A r and omized treatment comparison was implemented in a refugee camp in a severely affected community . 31 children who presented with a preliminary diagnosis of PTSD were r and omly assigned either to six sessions Narrative Exposure Therapy for children ( KIDNET ) or six sessions of meditation-relaxation ( MED-RELAX ) . Outcome measures included severity of PTSD symptoms , level of functioning and physical health . Results In both treatment conditions , PTSD symptoms and impairment in functioning were significantly reduced at one month post-test and remained stable over time . At 6 months follow-up , recovery rates were 81 % for the children in the KIDNET group and 71 % for those in the MED-RELAX group . There was no significant difference between the two therapy groups in any outcome measure . Conclusion As recovery rates in the treatment groups exceeded the expected rates of natural recovery , the study provides preliminary evidence for the effectiveness of NET as well as meditation-relaxation techniques when carried out by trained local counselors for the treatment of PTSD in children in the direct aftermath of mass disasters . Trial registration Clinical Trials.gov Identifier : CONTEXT Despite the importance of mental illness in Africa , few controlled intervention trials related to this problem have been published . OBJECTIVES To test the efficacy of group interpersonal psychotherapy in alleviating depression and dysfunction and to evaluate the feasibility of conducting controlled trials in Africa . DESIGN , SETTING , AND PARTICIPANTS For this cluster r and omized , controlled clinical trial ( February-June 2002 ) , 30 villages in the Masaka and Rakai districts of rural Ug and a were selected using a r and om procedure ; 15 were then r and omly assigned for study ing men and 15 for women . In each village , adult men or women believed by themselves and other villagers to have depressionlike illness were interviewed using a locally adapted Hopkins Symptom Checklist and an instrument assessing function . Based on these interviews , lists were created for each village totaling 341 men and women who met Diagnostic and Statistical Manual of Mental Disorders , Fourth Edition ( DSM-IV ) criteria for major depression or subsyndromal depression . Interviewers revisited them in order of decreasing symptom severity until they had 8 to 12 persons per village , totaling 284 . Of these , 248 agreed to be in the trial and 9 refused ; the remainder died or relocated . A total of 108 men and 116 women completed the study and were reinterviewed . INTERVENTION Eight of the 15 male villages and 7 of the 15 female villages were r and omly assigned to the intervention arm and the remainder to the control arm . The intervention villages received group interpersonal psychotherapy for depression as weekly 90-minute sessions for 16 weeks . MAIN OUTCOME MEASURES Depression and dysfunction severity scores on scales adapted and vali date d for local use ; proportion of persons meeting DSM-IV major depression diagnostic criteria . RESULTS Mean reduction in depression severity was 17.47 points for intervention groups and 3.55 points for controls ( P<.001 ) . Mean reduction in dysfunction was 8.08 and 3.76 points , respectively ( P<.001 ) . After intervention , 6.5 % and 54.7 % of the intervention and control groups , respectively , met the criteria for major depression ( P<.001 ) compared with 86 % and 94 % , respectively , prior to intervention ( P = .04 ) . The odds of postintervention depression among controls was 17.31 ( 95 % confidence interval , 7.63 - 39.27 ) compared with the odds among intervention groups . Results from intention-to-treat analyses remained statistically significant . CONCLUSIONS Group interpersonal psychotherapy was highly efficacious in reducing depression and dysfunction . A clinical trial proved feasible in the local setting . Both findings should encourage similar trials in similar setting s in Africa and beyond Background Infection with severe malaria in African children is associated with not only a high mortality but also a high risk of cognitive deficits . There is evidence that interventions done a few years after the illness are effective but nothing is known about those done immediately after the illness . We design ed a study in which children who had suffered from severe malaria three months earlier were enrolled into a cognitive intervention program and assessed for the immediate benefit in cognitive , academic and behavioral outcomes . Methods This parallel group r and omised study was carried out in Kampala City , Ug and a between February 2008 and October 2010 . Sixty-one Ug and an children aged 5 to 12 years with severe malaria were assessed for cognition ( using the Kaufman Assessment Battery for Children , second edition and the Test of Variables of Attention ) , academic skills ( Wide Range Achievement Test , third edition ) and psychopathologic behaviour ( Child Behaviour Checklist ) three months after an episode of severe malaria . Twenty-eight were r and omised to sixteen sessions of computerised cognitive rehabilitation training lasting eight weeks and 33 to a non-treatment group . Post-intervention assessment s were done a month after conclusion of the intervention . Analysis of covariance was used to detect any differences between the two groups after post-intervention assessment , adjusting for age , sex , weight for age z score , quality of the home environment , time between admission and post-intervention testing and pre-intervention score . The primary outcome was improvement in attention scores for the intervention group . This trial is registered with Current Controlled Trials , number IS RCT N53183087 . Results Significant intervention effects were observed in the intervention group for learning mean score ( SE ) , [ 93.89 ( 4.00 ) vs 106.38 ( 4.32 ) , P = 0.04 ] but for working memory the intervention group performed poorly [ 27.42 ( 0.66 ) vs 25.34 ( 0.73 ) , P = 0.04 ] . No effect was observed in the other cognitive outcomes or in any of the academic or behavioural measures . Conclusions In this pilot study , our computerised cognitive training program three months after severe malaria had an immediate effect on cognitive outcomes but did not affect academic skills or behaviour . Larger trials with follow-up after a few years are needed to investigate whether the observed benefits are sustained . Trial registration IS RCT N : IS RCT BACKGROUND The ability of specific behaviour-change interventions to reduce HIV infection in young people remains question able . Since January 1999 , an adolescent sexual and reproductive health ( SRH ) intervention has been implemented in ten r and omly chosen intervention communities in rural Tanzania , within a community r and omised trial ( see below ; NCT00248469 ) . The intervention consisted of teacher-led , peer-assisted in-school education , youth-friendly health services , community activities , and youth condom promotion and distribution . Process evaluation in 1999 - 2002 showed high intervention quality and coverage . A 2001/2 intervention impact evaluation showed no impact on the primary outcomes of HIV seroincidence and herpes simplex virus type 2 ( HSV-2 ) seroprevalence but found substantial improvements in SRH knowledge , reported attitudes , and some reported sexual behaviours . It was postulated that the impact on " upstream " knowledge , attitude , and reported behaviour outcomes seen at the 3-year follow-up would , in the longer term , lead to a reduction in HIV and HSV-2 infection rates and other biological outcomes . A further impact evaluation survey in 2007/8 ( approximately 9 years post-intervention ) tested this hypothesis . METHODS AND FINDINGS This is a cross-sectional survey ( June 2007 through July 2008 ) of 13,814 young people aged 15 - 30 y who had attended trial schools during the first phase of the MEMA kwa Vijana intervention trial ( 1999 - 2002 ) . Prevalences of the primary outcomes HIV and HSV-2 were 1.8 % and 25.9 % in males and 4.0 % and 41.4 % in females , respectively . The intervention did not significantly reduce risk of HIV ( males adjusted prevalence ratio [ aPR ] 0.91 , 95%CI 0.50 - 1.65 ; females aPR 1.07 , 95%CI 0.68 - 1.67 ) or HSV-2 ( males aPR 0.94 , 95%CI 0.77 - 1.15 ; females aPR 0.96 , 95%CI 0.87 - 1.06 ) . The intervention was associated with a reduction in the proportion of males reporting more than four sexual partners in their lifetime ( aPR 0.87 , 95%CI 0.78 - 0.97 ) and an increase in reported condom use at last sex with a non-regular partner among females ( aPR 1.34 , 95%CI 1.07 - 1.69 ) . There was a clear and consistent beneficial impact on knowledge , but no significant impact on reported attitudes to sexual risk , reported pregnancies , or other reported sexual behaviours . The study population was likely to have been , on average , at lower risk of HIV and other sexually transmitted infections compared to other rural population s , as only youth who had reached year five of primary school were eligible . CONCLUSIONS SRH knowledge can be improved and retained long-term , but this intervention had only a limited effect on reported behaviour and no significant effect on HIV/STI prevalence .  Youth interventions integrated within intensive , community-wide risk reduction programmes may be more successful and should be evaluated . TRIAL REGISTRATION Clinical Trials.gov BACKGROUND In situations of ongoing violence , childhood psychosocial and mental health problems require care . However , re sources and evidence for adequate interventions are scarce for children in low- and middle-income countries . This study evaluated a school-based psychosocial intervention in conflict-affected , rural Nepal . METHODS A cluster r and omized controlled trial was used to evaluate changes on a range of indicators , including psychiatric symptoms ( depression , anxiety , posttraumatic stress disorder ) , psychological difficulties , resilience indicators ( hope , prosocial behavior ) and function impairment .  Children ( n = 325 ) ( mean age = 12.7 , SD = 1.04 , range 11 - 14 years ) with elevated psychosocial distress were allocated to a treatment or waitlist group . RESULTS Comparisons of crude change scores showed significant between-group differences on several outcome indicators , with moderate effect sizes ( Cohen d = .41 to .58 ) . After correcting for nested variance within schools , no evidence for treatment effects was found on any outcome variable . Additional analyses showed gender effects for treatment on prosocial behavior ( mean change difference : 2.70 ; 95 % CI , .97 to 4.44 ) , psychological difficulties ( -2.19 ; 95 % CI , -3.82 to -.56 ) , and aggression ( -4.42 ; 95 % CI , -6.16 to -2.67 ) . An age effect for treatment was found for hope ( .90 ; 95 % CI , -1.54 to -.26 ) . CONCLUSIONS A school-based psychosocial intervention demonstrated moderate short-term beneficial effects for improving social-behavioral and resilience indicators among subgroups of children exposed to armed conflict . The intervention reduced psychological difficulties and aggression among boys , increased prosocial behavior among girls , and increased hope for older children . The intervention did not result in reduction of psychiatric symptoms BACKGROUND Depression in women is one of the commonest problems encountered in primary care . We aim ed to compare the effectiveness of a stepped-care programme with usual care in primary -care management of  depression in low-income women in Santiago , Chile . METHODS In a r and omised controlled trial , in three primary -care clinics in Chile , 240 adult female primary -care patients with major depression were allocated stepped care or usual care . Stepped care was a 3-month , multicomponent intervention led by a non-medical health worker , which included a psychoeducational group intervention , structured and systematic follow-up , and drug treatment for patients with severe depression . Data were analysed on an intention-to-treat basis . The primary outcome measure was the Hamilton depression rating scale ( HDRS ) administered at baseline and at 3 and 6 months after r and omisation . FINDINGS About 90 % of r and omised patients completed outcome assessment s. There was a substantial between-group difference in all outcome measures in favour of the stepped-care programme . The adjusted difference in mean HDRS score between the groups was -8.89 ( 95 % CI -11.15 to -6.76 ; p<0.0001 ) . At 6-months ' follow-up , 70 % ( 60 - 79 ) of the stepped-care compared with 30 % ( 21 - 40 ) of the usual-care group had recovered ( HDRS score < 8) . INTERPRETATION Despite few re sources and marked deprivation , women with major depression responded well to a structured , stepped-care treatment programme , which is being introduced across Chile . Socially disadvantaged patients might gain the most from systematic improvements in treatment of depression OBJECTIVE To compare the efficacy of an outreach program for young children with cerebral palsy with center-based and " minimal intervention " control groups . DESIGN R and omized controlled trial conducted in a group of 85 children between the ages of 1.5 and 5 years . Urban children were allocated to 
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Results In behavioural disorders parent training is a highly promising intervention , which can successfully improve children ’s compliance and bring down rates of conduct problems significantly .
In young children  cognitive , emotional and behavioural development can be enhanced through nutritional supplements and by stimulation through play , praise and reading .
Trauma treatments can bring positive results even in severely traumatised children , who remain in unstable living conditions .
In developmental disorders , there are successful prevention strategies as well as programmes that bring children out of isolation and improve their independence .
Some classroom-based interventions for adolescents have reduced symptoms of common mental disorders as well as risk taking behaviours .
Conclusions While many results are still tentative the evidence suggests that it is possible to develop affordable and feasible interventions that significantly improve the lives of affected children , their families and their communities around the world