***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: This study employed a self-report question naire in a Solomon four-groups design to assess the efficacy of suicide intervention classes in achieving their instructional objectives . Because adolescents are often the first to know of a peer 's suicidal thoughts or plans , the goal of the classes was to increase the likelihood that students who come into contact with potentially suicidal peers can more readily identify them and will be consistently inclined to take responsible action on their behalf . Students who participated in the classes as compared to controls showed significant gains in relevant knowledge about suicidal peers and significantly more positive attitudes toward help seeking and intervening with troubled peers . Results of this study will be used to strengthen components of the lessons aim ed at enhancing the likelihood of performance of responsible interventions The effectiveness of a school-based primary prevention psychological program is assessed in the present study . The program was design ed to ( a ) improve students ' distress-coping , ( b ) prepare them as " gatekeepers " with regard to self-destructive behavior of peers and ( c ) assess the program 's face validity and social validity . The program was primarily based on cognitive-behavioral modification principles , procedures and techniques . Two hundred and thirty-seven students , drawn from six homeroom grade eight classes were r and omly assigned to experimental and control ( no intervention ) conditions . The program consisted of seven units passed during twelve weekly one-hour sessions . Overall , the program had a positive effect on attitudes , emotions , knowledge and awareness of distress coping skills . In addition , it had some degree of face validity and social validity from the students ' vantage point . These results lend support to the feasibility of a  cognitive-behavioral , school-based prevention program for students ' distress-coping enhancement OBJECTIVES We examined the effectiveness of the Signs of Suicide ( SOS ) prevention program in reducing suicidal behavior . METHODS Twenty-one hundred students in 5 high schools in Columbus , Ga , and Hartford , Conn , were r and omly assigned to intervention and control groups . Self-administered question naires were completed by students in both groups approximately 3 months after program implementation . RESULTS Significantly lower rates of suicide attempts and greater knowledge and more adaptive attitudes about depression and suicide were observed among students in the intervention group . The modest changes in knowledge and attitudes partially explained the beneficial effects of the program . CONCLUSIONS SOS is the first school-based suicide prevention program to demonstrate significant reductions in self-reported suicide attempts BACKGROUND Psycho-educational programs are among the most commonly applied suicide prevention approaches for young people . This study examined the effectiveness of these programs in a controlled study by assessing the effect on knowledge , attitudes , coping and hopelessness . METHOD Fourteen- to 18-year-old students were administered structured question naires before and after the program to assess the effect on knowledge , attitudes , coping and hopelessness . RESULTS The program had no effect on coping styles and levels of hopelessness . However , a positive effect on knowledge could be identified and an interaction effect of the program with gender on attitudes was also found . A negative impact of the program could not be found . Results indicated effects of gender and pre-test on knowledge , attitudes and coping . CONCLUSIONS The findings from this study suggest that psycho-educational programs in schools may influence knowledge about suicide and attitudes towards suicidal persons but may not affect the use of coping styles or levels of hopelessness OBJECTIVE : To test the feasibility of creating a valid and reliable checklist with the following features : appropriate for assessing both r and omised and non-r and omised studies ; provision of both an overall score for study quality and a profile of scores not only for the quality of reporting , internal validity ( bias and confounding ) and power , but also for external validity . DESIGN : A pilot version was first developed , based on epidemiological principles , review s , and existing checklists for r and omised studies . Face and content validity were assessed by three experienced review ers and reliability was determined using two raters assessing 10 r and omised and 10 non-r and omised studies . Using different raters , the checklist was revised and tested for internal consistency ( Kuder-Richardson 20 ) , test-retest and inter-rater reliability ( Spearman correlation coefficient and sign rank test ; kappa statistics ) , criterion validity , and respondent burden . MAIN RESULTS : The performance of the checklist improved considerably after revision of a pilot version . The Quality Index had high internal consistency ( KR-20 : 0.89 ) as did the subscales apart from external validity ( KR-20 : 0.54 ) . Test-retest ( r 0.88 ) and inter-rater ( r 0.75 ) reliability of the Quality Index were good . Reliability of the subscales varied from good ( bias ) to poor ( external validity ) . The Quality Index correlated highly with an existing , established instrument for assessing r and omised studies ( r 0.90 ) . There was little difference between its performance with non-r and omised and with r and omised studies . Raters took about 20 minutes to assess each paper ( range 10 to 45 minutes ) . CONCLUSIONS : This study has shown that it is feasible to develop a checklist that can be used to assess the method ological quality not only of r and omised controlled trials but also non-r and omised studies . It has also shown that it is possible to produce a checklist that provides a profile of the paper , alerting review ers to its particular method ological strengths and weaknesses . Further work is required to improve the checklist and the training of raters in the assessment of external validity This study employed simulations of encounters with suicidal peers to assess the impact of classroom suicide response lessons . Students were asked to anonymously write how they would respond , and how concerned they would be in regard to two vignettes of troubled peers . On the posttest , students who had participated in the classes provided significantly more " tell an adult " responses than those in the control group , whereas no differences existed between the groups on the pretest . On both the pretest and posttest , all students expressed greater concern on the unambiguous vignette ( student said that he has been thinking about killing himself ) than on the ambiguous vignette ( student wrote an essay about final decisions ) ; and , overall , females expressed greater concern than males . These results provide evidence for the efficacy of the classes and the utility of the simulations for assessing their impact 
    Output:
    
Overall , statistically significant improvements were noted in knowledge , attitude , and help-seeking behaviour .
CONCLUSION Although evidence exists that school-based programmes to prevent suicide among adolescents improve knowledge , attitudes , and help-seeking behaviours , no evidence yet exists that these prevention programmes reduce suicide rates .