***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: OBJECTIVE Youth in war-affected regions are at risk for poor psychological , social , and educational outcomes . Effective interventions are needed to improve mental health , social behavior , and school functioning . This r and omized controlled trial tested the effectiveness of a 10-session cognitive-behavioral therapy (CBT)-based group mental health intervention for multisymptomatic war-affected youth ( aged 15 - 24 years ) in Sierra Leone . METHOD War-affected youth identified by elevated distress and impairment via community screening were r and omized ( stratified by sex and age ) to the Youth Readiness Intervention ( YRI ) ( n = 222 ) or to a control condition ( n = 214 ) . After treatment , youth were again r and omized and offered an education subsidy immediately ( n = 220 ) or waitlisted ( n = 216 ) . Emotion regulation , psychological distress , prosocial attitudes/behaviors , social support , functional impairment , and posttraumatic stress disorder ( PTSD ) symptoms were assessed at pre- and postintervention and at 6-month follow-up . For youth in school , enrollment , attendance , and classroom performance were assessed after 8 months . Linear mixed-effects regressions evaluated outcomes . RESULTS The YRI showed significant postintervention effects on emotion regulation , prosocial attitudes/behaviors , social support , and reduced functional impairment , and significant follow-up effects on school enrollment , school attendance , and classroom behavior . In contrast , education subsidy was associated with better attendance but had no effect on mental health or functioning , school retention , or classroom behavior . Interactions between education subsidy and YRI were not significant . CONCLUSION YRI produced acute improvements in mental health and functioning as well as longer-term effects on school engagement and behavior , suggesting potential to prepare war-affected youth for educational and other opportunities . Clinical trial registration information-Trial of the Youth Readiness Intervention ( YRI ) ; http:// clinical trials.gov ; NCT01684488 This study evaluated the effects of Group Triple P with Chinese parents on parenting and child outcomes  as well as outcomes relating to child academic learning  in Mainl and China . Participants were 81 Chinese parents and their children in Shanghai , who were r and omly allocated to an intervention group or wait-list control group . Parents in the intervention condition received Group Triple P training , and parents and children were assessed at three/two time points . Compared with the control group , parents in the intervention group reported significant improvements in child adjustment problems , parenting practice s , parental adjustment , and parenting self-efficacy at post- assessment . Moreover , there was a significant increase in parents ’ satisfaction with children ’s academic achievement and a reduction in children ’s academic problem behaviors at post-intervention . All these effects were maintained at 6-month follow-up . There was also a significant increase in the child report of positive parenting at post-intervention OBJECTIVE To assess the efficacy of trauma-focused cognitive behavioral therapy ( TF-CBT ) delivered by non clinical facilitators in reducing posttraumatic stress , depression , and anxiety and conduct problems and increasing prosocial behavior in a group of war-affected , sexually exploited girls in a single-blind , parallel- design , r and omized,+ controlled trial . METHOD Fifty-two 12- to 17-year-old , war-affected girls exposed to rape and inappropriate sexual touch in the Democratic Republic of Congo were screened for trauma , depression and anxiety , conduct problems , and prosocial behavior . They were then r and omized to a 15 session , group-based , culturally modified TF-CBT ( n = 24 ) group or a wait-list control group ( n = 28 ) . Primary analysis , by intention-to-treat , involving all r and omly assigned participants occurred at pre- and postintervention and at 3-month follow-up ( intervention group only ) . RESULTS Compared to the wait list control , the TF-CBT group experienced significantly greater reductions in trauma symptoms ( F(1,49 ) = 52.708 , p<0·001 , χ(p)2 = 0.518 ) . In addition , the TF-CBT group showed a highly significant improvement in symptoms of depression and anxiety , conduct problems , and prosocial behavior . At 3-months follow-up the effect size ( Cohen 's d ) for the TF-CBT group was 2.04 ( trauma symptoms ) , 2.45 ( depression and anxiety ) , 0.95 ( conduct problems ) , and -1.57 ( prosocial behavior ) . CONCLUSIONS A group-based , culturally modified , TF-CBT intervention delivered by non clinical ly trained Congolese facilitators result ed in a large , statistically significant reduction in posttraumatic stress symptoms and psychosocial difficulties among war-affected girls exposed to rape or sexual violence . Clinical trial registration information-An RCT of TF-CBT with sexually-exploited , war-affected girls in the DRC ; http:// clinical trials.gov/ ; NCT01483261 BACKGROUND The Democratic Republic of Congo ( DRC ) has been home to the world 's deadliest conflict since World War II and is reported to have the largest number of child soldiers in the world . Despite evidence of the debilitating impact of war , no group-based mental health or psychosocial intervention has been evaluated in a r and omised controlled trial for psychologically distressed former child soldiers . METHOD A r and omised controlled trial involving 50 boys , aged 13 - 17 , including former child soldiers ( n = 39 ) and other war-affected boys ( n = 11 ) . They were r and omly assigned to an intervention group , or wait-list control group . The intervention group received a 15-session , group-based , culturally adapted Trauma-Focused Cognitive-Behavioural Therapy ( TF-CBT ) intervention . Assessment interviews were completed at baseline , postintervention and 3-month follow-up ( intervention group ) . RESULTS Analysis of Covariance ( ANCOVA ) demonstrated that , in comparison to the wait-list control group , the TF-CBT intervention group had highly significant reductions in posttraumatic stress symptoms , overall psychosocial distress , depression or anxiety-like symptoms , conduct problems and a significant increase in prosocial behaviour ( p < .001 for all ) . Effect sizes were higher when former child soldier scores were separated for sub- analysis . Three-month follow-up of the intervention group found that treatment gains were maintained . CONCLUSIONS A culturally modified , group-based TF-CBT intervention was effective in reducing posttraumatic stress and psychosocial distress in former child soldiers and other war-affected boys Objective : The objective of this study is to assess the efficacy of an intervention design ed to promote resilience in young children living with their HIV-positive mothers . Design / methods : HIV-positive women attending clinics in Tshwane , South Africa , and their children , aged 6–10 years , were r and omized to the intervention ( I ) or st and ard care ( S ) . The intervention consisted of 24 weekly group sessions led by community care workers . Mothers and children were in separate groups for 14 sessions , followed by 10 interactive sessions . The primary focus was on parent – child communication and parenting . Assessment s were completed by mothers and children at baseline and 6 , 12 and 18 months . Repeated mixed linear analyses were used to assess change over time . Results : Of 390 mother – child pairs , 84.6 % ( I : 161 and S : 169 ) completed at least two interviews and were included in the analyses . Children 's mean age was 8.4 years and 42 % of mothers had been ill in the prior 3 months . Attendance in groups was variable : only 45.7 % attended more than 16 sessions . Intervention mothers reported significant improvements in children 's externalizing behaviours ( ß = –2.8 , P = 0.002 ) , communication ( ß = 4.3 , P = 0.025 ) and daily living skills ( ß = 5.9 , P = 0.024 ) , although improvement in internalizing behaviours and socialization was not significant ( P = 0.061 and 0.052 , respectively ) . Intervention children reported a temporary increase in anxiety but did not report differences in depression or emotional intelligence . Conclusion : This is the first study demonstrating benefits of an intervention design ed to promote resilience among young children of HIV-positive mothers . The intervention was specifically design ed for an African context and has the potential to benefit large numbers of children , if it can be widely implemented Background There is an urgent need for effective , affordable interventions to prevent child mental health problems in low- and middle-income countries . Aims To determine the effects of a universal pre-school-based intervention on child conduct problems and social skills at school and at home . Method In a cluster r and omised design , 24 community pre-schools in inner-city areas of Kingston , Jamaica , were r and omly assigned to receive the Incredible Years Teacher Training intervention ( n = 12 ) or to a control group ( n = 12 ) . Three children from each class with the highest levels of teacher-reported conduct problems were selected for evaluation , giving 225 children aged 3–6 years . The primary outcome was observed child behaviour at school . Secondary outcomes were child behaviour by parent and teacher report , child attendance and parents ’ attitude to school . The study is registered as IS RCT N35476268 . Results Children in intervention schools showed significantly reduced conduct problems ( effect size ( ES ) = 0.42 ) and increased friendship skills ( ES = 0.74 ) through observation , significant reductions to teacher-reported ( ES = 0.47 ) and parent-reported ( ES = 0.22 ) behaviour difficulties and increases in teacher-reported social skills ( ES = 0.59 ) and child attendance ( ES = 0.30 ) . Benefits to parents ’ attitude to school were not significant . Conclusions A low-cost , school-based intervention in a middle-income country substantially reduces child conduct problems and increases child social skills at home and at school Flaws in the design , conduct , analysis , and reporting of r and omised trials can cause the effect of an intervention to be underestimated or overestimated . The Cochrane Collaboration ’s tool for assessing risk of bias aims to make the process clearer and more OBJECTIVE To evaluate the effect of a preventative intervention in Jamaican basic schools on child behaviour and parent-teacher contacts . DESIGN AND METHODS Five basic schools in Kingston , Jamaica , were r and omly assigned to an intervention ( n = 3 ) or control ( n = 2 ) condition . Intervention involved seven whole-day teacher workshops using the Incredible Years Teacher Training Programme supplemented by fourteen lessons on social and emotional skills in each class .  Within each classroom ( n = 27 ) , children were screened for behaviour difficulties through teacher report and children with the greatest difficulties were selected for evaluation of outcomes ( 135 children ) .  Teachers'reports of child behaviour using the Strengths and Difficulties Question naire and of the quality of teacher-parent contacts were collected at the beginning and end of the school year Multilevel regression analyses controlling for school and classroom were used to evaluate the effects of intervention on child behaviour . RESULTS Significant benefits of intervention were found for children 's conduct problems ( regression coefficient ( b ) = -0.62 , 95 % confidence interval ( CI ) : -0.01 , -1.23 ) , hyperactivity ( b = -0.84 , 95 % CI : -1.57 , -0.11 ) and peer problems ( b = -1.24 , 95 % CI : -1.89 , -0.59 ) . The effect sizes were 0.26 for conduct problems , 0.36 for hyperactivity and 0.71 for peer problems . No significant benefits were found for the prosocial and emotional problems subscales . The intervention also result ed in increases in the number of positive teacher-parent contacts ( p < 0.0001 ) . No benefits were found for the number of negative teacher-parent contacts . CONCLUSION This is a promising approach for reducing children  's  externalizing behaviour and peer problems and for improving the quality of teachers ' contacts with parents of children with behaviour problems CONTEXT Prior qualitative work with internally displaced persons in war-affected northern Ug and a showed significant mental health and psychosocial problems . OBJECTIVE To assess effect of locally feasible interventions on depression , anxiety , and conduct problem symptoms among adolescent survivors of war and displacement in northern Ug and a. DESIGN , SETTING , AND PARTICIPANTS A r and omized controlled trial from May 2005 through December 2005 of 314 adolescents ( aged 14 - 17 years ) in 2 camps for internally displaced persons in northern Ug and a. INTERVENTIONS Locally developed screening tools assessed the effectiveness of interventions in reducing symptoms of depression and anxiety , ameliorating conduct problems , and improving function among those who met study criteria and were r and omly allocated ( 105 , psychotherapy-based intervention [ group interpersonal psychotherapy ] ; 105 , activity-based intervention [ creative play ] ; 104 , wait-control group [ individuals wait listed to receive treatment at study end ] ) . Intervention groups met weekly for 16 weeks . Participants and controls were reassessed at end of study . MAIN OUTCOME MEASURES Primary measure was a decrease in score ( denoting improvement ) on a depression symptom scale . Secondary measures were improvements in scores on anxiety , conduct problem symptoms , and function scales . Depression , anxiety , and conduct problems were assessed using the Acholi Psychosocial Assessment Instrument with a minimum score of 32 as the lower limit for clinical ly significant symptoms ( maximum scale score , 105 ) . RESULTS Difference in change in adjusted mean score for depression symptoms between group interpersonal psychotherapy and control 
    Output:
    
Our meta- analysis supports the use of psychosocial interventions as a feasible and effective way to reduce  disruptive behaviour problems among children in LMIC .
Our study provides strong evidence for child-focused and behavioural parenting interventions , interventions across age ranges and interventions delivered in groups .