***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: Purpose : The aim of this study was to examine the influence of selected exercises on motor development in elementary school third grade girl students in Ahwaz City , Iran . Methods : The present study was semi-experimental , performed as field and using experimental and control groups . The statistical population included all third grade girl students of elementary schools of Ahvaz city ( 10,500 subjects ) . Forty of whom were r and omly selected ( cluster stage ) and then were divided r and omly into two experimental ( N = 20 , M age = 8.9 ± 0.49 ) and control ( N = 20 , M age = 8.9 ± 0.48 ) groups . Experimental group was given training for eight weeks , 3 sessions per week and each session lasting 45 minutes . To measure motor development , the Test of Gross Motor Development , edition2 ( TGMD-2 ; 2002 ) was applied . Statistical analysis was performed using independent t-test and paired t-test . Results : The results showed statistically significant differences between control and experimental groups regarding locomotion skills ( 8.433 , P < 0.05 ) , manipulation skills ( 10.951 , P < 0.001 ) and overall motor development ( 13.203 , P < 0.001 ) . In fact , selected exercises impacted on the motor development of subjects and led to their motor development progress . Conclusions : The selected exercises can be used as an appropriate plan to improve motor skill development in third grade of elementary school Background The physical activity ( PA ) levels of many children and adolescents in Australia are currently insufficient to promote health benefits . Physical education ( PE ) programs aim to promote PA and reach nearly all school-aged children , but PA levels within PE lessons are often low . PE teachers may influence children ’s motivation to be physically active in PE lessons , but little is known about teacher strategies that effectively motivate children to participate in PA , and few intervention studies have examined motivational strategies in PE . The purpose of this study was to compare the effect of three motivational strategies , each based on Self-Determination Theory ( SDT ) , on PA levels , and their hypothesized antecedents , during year 8 PE lessons . Methods / design This study employed a cluster-r and omized controlled trial design . Following a familiarization session , PA levels and hypothesized PA antecedents were measured during a baseline lesson and a post-intervention or control lesson .  Teachers ( n = 16 ) and their classes from five secondary schools in Sydney , Australia were r and omly assigned into four blocks and instructed to provide one of four 20-min lesson teaching strategy conditions : ( 1 ) explaining the relevance of activities ; ( 2 ) providing choice from PA options selected by the teacher ; ( 3 ) providing equipment and free choice of activities ; or ( 4 ) usual practice . The primary outcomes were lesson time spent in moderate-to-vigorous PA , and motivation towards the lesson . Secondary outcomes were perceptions of teacher behavior , psychological needs satisfaction , and lesson time spent in sedentary behavior . PA and sedentary behavior were measured during baseline and post-intervention lessons with waist-mounted Actigraph GT3X accelerometers . Teacher behavior , psychological needs satisfaction , and motivation were assessed via question naires at the end of each lesson . Linear mixed-model analyses will be run on all outcomes , with students nested within teachers as a r and om effect . Discussion Study findings will inform the development of effective SDT-based teaching strategy interventions to enhance students ’ psychological needs satisfaction , motivation , and PA levels . More effective teaching strategies may be identified that are capable of improving  adolescents ’ PA levels , and thereby provide beneficial population health outcomes .Trial registration This trial is registered with Current Controlled Trials and is traceable as IS RCT N07038258 OBJECTIVE To evaluate the impact of a school-based health behavior intervention known as Planet Health on obesity among boys and girls in grade s 6 to 8 . DESIGN R and omized , controlled field trial with 5 intervention and 5 control schools . Outcomes were assessed using preintervention ( fall 1995 ) and follow-up measures ( spring 1997 ) , including prevalence , incidence , and remission of obesity . PARTICIPANTS A group of 1295 ethnically diverse grade 6 and 7 students from public schools in 4 Massachusetts communities . INTERVENTION Students participated in a school-based interdisciplinary intervention over 2 school years . Planet Health sessions were included within existing curricula using classroom teachers in 4 major subjects and physical education . Sessions focused on decreasing television viewing , decreasing consumption of high-fat foods , increasing fruit and vegetable intake , and increasing moderate and vigorous physical activity . MAIN OUTCOME MEASURES Obesity was defined as a composite indicator based on both a body mass index and a triceps skinfold value greater than or equal to age- and sex-specific 85th percentiles . Because schools were r and omized , rather than students , the generalized estimating equation method was used to adjust for individual-level covariates under cluster r and omization . RESULTS The prevalence of obesity among girls in intervention schools was reduced compared with controls , controlling for baseline obesity ( odds ratio , 0.47 ; 95 % confidence interval , 0.24 - 0.93 ; P = .03 ) , with no differences found among boys . There was greater remission of obesity among intervention girls vs. control girls ( odds ratio , 2.16 ; 95 % confidence interval , 1.07 - 4.35 ; P = .04 ) . The intervention reduced television hours among both girls and boys , and increased fruit and vegetable consumption and result ed in a smaller increment in total energy intake among girls . Reductions in television viewing predicted obesity change and mediated the intervention effect . Among girls , each hour of reduction in television viewing predicted reduced obesity prevalence ( odds ratio , 0.85 ; 95 % confidence interval , 0.75 - 0.97 ; P = .02 ) . CONCLUSION Planet Health decreased obesity among female students , indicating a promising school-based approach to reducing obesity among youth The HEALTHY study was a multi-site r and omized trial design ed to determine whether a 3-year school-based intervention targeting nutrition and physical activity behaviors could effectively reduce risk factors associated with type 2 diabetes in middle school children . Pilot and formative studies were conducted to inform the development of the intervention components and the process evaluation methods for the main trial . During the main trial , both qualitative and quantitative assessment s monitored the fidelity of the intervention and motivated modifications to improve intervention delivery . Structured observations of physical education classes , total school food environments , classroom-based educational modules , and communications and promotional campaigns provided verification that the intervention was delivered as intended . Interviews and focus groups yielded a multidimensional assessment of how the intervention was delivered and received , as well as identifying the barriers to and facilitators of the intervention across and within participating schools . Interim summaries of process evaluation data were presented to the study group as a means of ensuring st and ardization and quality of the intervention across the seven participating centers . Process evaluation methods and procedures documented the fidelity with which the HEALTHY study was implemented across 21 intervention schools and identified ways in which the intervention delivery might be enhanced throughout the study Background Many Australian children are insufficiently active to accrue health benefits and physical activity ( PA ) levels are consistently lower among youth of low socio-economic position .  PA levels decline dramatically during adolescence and evidence suggests that competency in a range of fundamental movement skills ( FMS ) may serve as a protective factor against this trend . Methods / design The Supporting Children ’s Outcomes Using Rewards Exercise and Skills ( SCORES ) intervention is a multi-component PA and FMS intervention for primary schools in low-income communities , which will be evaluated using a group r and omized controlled trial . The socio-ecological model provided a framework for the 12-month intervention , which includes the following components : teacher professional learning , student leadership workshops ( including leadership accreditation and rewards , e.g. , stickers , water bottles ) , PA policy review , PA equipment packs , parental engagement via newsletters , FMS homework and a parent evening , and community partnerships with local sporting organizations . Outcomes will be assessed at baseline , 6- and 12-months . The primary outcomes are PA ( accelerometers ) , FMS ( Test of Gross Motor Development II ) and cardiorespiratory fitness ( multi-stage fitness test ) . Secondary outcomes include body mass index [ using weight (kg)/height ( m2 ) ] , perceived competence , physical self-esteem , and resilience . Individual and environmental mediators of behavior change ( e.g. social support and enjoyment ) will also be assessed . The System for Observing Fitness Instruction Time will be used to assess the impact of the intervention on PA within physical education lessons . Statistical analyses will follow intention-to-treat principles and hypothesized mediators of PA behavior change will be explored . Discussion SCORES is an innovative primary school-based PA and FMS intervention design ed to support students attending schools in low-income communities to be more skilled and active . The findings from the study may be used to guide teacher pre-service education , professional learning and school policy in primary schools . Trial registration Australian New Zeal and Clinical Trials Registry No : Background Childhood obesity is not only associated with adult obesity but also with increased risk of adult onset of type 2 diabetes and subsequent coronary heart disease . The potential effects of school-based health intervention programmes on cardiovascular risk and surrogate markers are unclear , as only few studies have attempted to investigate a complete risk profile including a detailed laboratory analysis or micro- and macrovascular function . In this study a comprehensive school-based r and omized intervention programme will be investigated in 10 - 14-year old children addressing the influence of lifestyle intervention on inactivity , cardiometabolic risk factors and early signs of vascular disease . Methods / Design 15 secondary schools in Southern Germany are r and omly assigned to intervention or control schools . Children in the fifth grade ( 10 - 11 years ) will be observed over four years . The study combines a school-based with a home-based approach , aim ing at children , teachers and parents . The main components are weekly lifestyle-lessons for children , taught by regular classroom teachers to increase physical activity in- and outside of school , to improve eating patterns at school and at home , to reduce media consumption and to amplify well-being . In 4 - 6 annual meetings , teachers receive information about health-related topics with worksheets for children and supporting equipment , accounting for school-specific needs and strategies . Parents ' trainings are provided on a regular basis . All examinations are performed at the beginning and at the end of every school year . Anthropometry includes measurements of BMI , waist and upper arm circumferences , skinfold thickness as well as peripheral blood pressure . Blood sampling includes lipid parameters , insulin , glucose , hsCRP , adiponectin , and IL-6 as well as testosteron and estrogen to determine maturation status . Vascular function is non-invasively assessed by measuring arterial stiffness in large arteries using a sphygmograph and by analysing arteriolar and venular diameters in the retinal microcirculation using a non-mydriatric vessel analyser . A question naire is filled out to determine daily physical activity , motivational factors , dietary habits , quality of life ( KINDL-R ) and socio-economic data . Physical fitness is assessed by a six-item test battery . Discussion Our study aims to provide a feasible long-term intervention strategy to re-establish childhood health and to prevent obesity-related cardiovascular dysfunction in children . Trial Registration BACKGROUND Physical activity is important for weight control and good health ; however , activity levels decline in the adolescent years , particularly in girls . DESIGN Group r and omized controlled trial . SETTING / PARTICIPANTS Middle school girls with English-speaking skills and no conditions to prevent participation in physical activity in 36 schools in six geographically diverse areas of the United States . R and om , cross-sectional sample s were drawn within schools : 6th grade rs in 2003 ( n=1721 ) and 8th grade rs in 2005 ( n=3504 ) and 2006 ( n=3502 ) . INTERVENTION A 2-year study -directed intervention ( fall 2003 to spring 2005 ) targeted schools , community agencies , and girls  to increase opportunities , support , and incentives for increased physical activity . Components included programs linking schools and community agencies , physical education , health education , and social marketing . A third-year intervention used school and community personnel to direct intervention activities . MAIN OUTCOME MEASURES The primary outcome , daily MET-weighted minutes of moderate-to-vigorous physical activity ( MET-weighted MVPA ) , was assessed using accelerometry . Percent body fat was assessed using anthropometry . RESULTS After the staff-directed intervention ( pre-stated primary outcome ) , there were no differences ( mean= -0.4 , 95 % CI= -8.2 to 7.4 ) in adjusted MET-weighted MVPA between 8th- grade girls in schools assigned to intervention or control . Following the Program Champion-directed intervention , girls in intervention schools were more physically active than girls in control schools ( mean difference 10.9 MET-weighted minutes of MVPA , 95 % CI=0.52 - 21.2 ) . This difference is about 1.6 minutes of daily MVPA or 80 kcal per week . There were no differences in fitness or percent body fat at either 8th- grade timepoint . CONCLUSION A school-based , community-linked intervention modestly improved physical activity in girls BACKGROUND Our objective was to evaluate the effects of environmental , policy , and social marketing interventions on physical activity and fat intake of middle school students on campus . DESIGN Twenty-four middle schools were r and omly assigned to intervention or control conditions . Baseline measures were collected in spring  
    Output:
    
It appears that teacher training programs : are ≥ 1 day ; provide comprehensive subject and pedagogy content ; are framed by a theory or model ; provide follow-up or ongoing support ; and measure teacher satisfaction of the training , are more effective at improving student outcomes in FMS and /or PA .
However , the provision of information regarding the characteristics of the teacher training was largely inadequate .
Therefore , it was difficult to ascertain which teacher training characteristics were most important in relation to intervention effectiveness .
What remains unclear , due to poor reporting , is what role teacher training is having on these outcomes