***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 Given the urgent need to develop effective programs that improve the ability for adolescents to achieve metabolic control equivalent to programs studied in the Diabetes . Control and Complications Trial , we have undertaken a clinical trial to determine if a behavioral intervention ( coping skills training [ CST ] ) combined with intensive diabetes management can improve metabolic control and quality of life in adolescents implementing intensive therapy regimens . RESEARCH DESIGN AND METHODS A total of 65 youths between the ages of 13 and 20 years , who elected to initiate intensive insulin therapy  , were r and omly assigned to one of two groups : the intensive management with CST group and the intensive management without CST group . CST consists of a series of small group efforts design ed to teach adolescents the coping skills of social problem-solving , social skills training , cognitive behavior modification , and conflict resolution . Data were collected at pre-intervention and at 3 months following the use of the Self-Efficacy for Diabetes scale , Children 's Depression Inventory , Issues in Coping with IDDM scale , and the Diabetes Quality of Life : Youth scale . Clinical data ( HbA1c , adverse effects ) were collected monthly . RESULTS The experimental and control groups were comparable on all measures at baseline . Results show that adolescents who received CST had lower HbA1c and better diabetes self-efficacy and were less upset about coping with diabetes than adolescents receiving intensive management alone . In addition , adolescents who received the CST found it easier to cope with diabetes and experienced less of a negative impact of diabetes on quality of life than those who did not receive CST . CONCLUSIONS CST is useful in improving not only an adolescent 's metabolic control , but also their quality of life . As more pediatric providers aim for improved control , in adolescents with diabetes , the addition of this behavioral intervention may be helpful in achieving metabolic and life goals PURPOSE Although cognitive-behavioral interventions have been successful in treating depression , no studies were found that focused solely on reducing negative thinking via group intervention as a means of preventing depression in at-risk groups . The purpose of this r and omized controlled trial was to test the effectiveness of a cognitive-behavioral group intervention in reducing depressive symptoms , decreasing negative thinking , and enhancing self-esteem in young women at risk for depression . DESIGN A r and omized controlled trial with 92 college women ages 18 to 24 who were at risk for depression was conducted . METHOD Participants were r and omly assigned to either the control or experimental group . The experimental group participated in a 6-week cognitive-behavioral group intervention . Data on self-esteem , depressive symptoms , and negative thinking were collected via self-report question naires from control and experimental groups at baseline , 1 month after the intervention , and at 6-month follow-up . Data were analyzed using mixed-model methodology and the Cochran-Mantel-Haenszel chi-square test . FINDINGS Compared to those in the control group , women who received the intervention had a greater decrease in depressive symptoms and negative thinking and a greater increase in self-esteem , and these beneficial effects were maintained over 6-months . CONCLUSIONS The findings document the effectiveness of this cognitive-behavioral group intervention and indicate empirical support for the beneficial effects of reducing negative thinking by the use of affirmations and thought-stopping techniques on women 's mental health Agreat deal of emphasis has been placed recently on the importance of high- quality evidence in medical literature .Placebo-controlled , r and omized , prospect i ve studies are valued especially highly . However , the fact that a study is placebo-controlled , r and omized , and prospect i ve does not necessarily mean that it was well design ed and well-reported , or that the conclusions are valid . In a recent article , Sinha et al highlighted this important issue in a review of r and omized trials published in high- quality surgical journals . ' The quality of the journal was determined by its impact factor . In analyzing the literature , Sinha et al used the Consoli date d St and ards of Reporting Trials ( CONSORT ) statement published in JAMAin 1996.2 The CONSORT statement result ed from international collaboration among biomedical editors , clinicians , and statisticians . In order to correct shortcomings in reporting of trial methodology , they promulgated a st and ardized framework to assist authors in reporting findings of clinical trials completely and transparently . The CONSORT statement was revised in 2001,3 and it can be accessed at www.consort-statement.org . Although following CONSORT guidelines improves reporting of clinical trials , and although the statement is accepted by many biomedical journals , it has not been used as widely as one might wish . In their study , Sinha et al analyzed 42 r and omized , controlled trials ( RCTs ) , calculating their Iadad scores .  The Iadad score is determined through assessment of questions addressing r and omization , blinding , and reporting of withdrawals and dropouts from studies . ' The Iadad score has been vali date d as a scale for assessing trial reporting quality and is used to distinguish low- quality from high- quality studies . Sinha et al used a Iadad score of ~3 for their threshold ( a conservative choice , since some authors require a score of ~4 ) . In the three high- quality journals they evaluated , PURPOSE The goal of the work described in this article was to test the possibility of preventing depression among adolescents with epilepsy . METHODS Adolescents with newly diagnosed epilepsy ( 104 patients ) were screened for depression . The risk for depression was increased in 30 ( 28.8 % ) patients ( mean age 17.4 , 60 % females ) who were r and omized into two equal treatment groups : ( 1 ) cognitive-behavioral intervention ( CBI ) group and ( 2 ) treatment with counseling as usual ( TAU ) group . The Beck Depression Inventory ( BDI ) , Center for Epidemiological Study on Depression ( CES-D ) scale , Hamilton Depression Scale ( HAMD ) , and Quality of Life in Epilepsy Inventory ( QOLIE-31 ) were administered at baseline and during the 9-month follow-up . RESULTS Initial BDI and HAMD scores for the two groups were comparable . Depression was diagnosed during follow-up in three patients in the TAU group . Subthreshold depressive disorder significantly improved at follow-up in the BCI group compared with the TAU group ( P<0.05 ) . QOLIE-31 Total scores significantly correlated with both mood improvement and seizure-free state BACKGROUND Children of adolescent mothers may suffer because of parenting inadequacies . The use of volunteer home visitors to enhance parenting skills has not been well studied . OBJECTIVE To evaluate the effect of a volunteer model home visitation program on  adolescent parenting outcomes . DESIGN R and omized trial with assignment to home visitation or control group . SETTING Urban , African American community . PARTICIPANTS Adolescents aged 12 to 18 years at 28 or more weeks ' gestation or who had delivered a baby in the past 6 months were recruited between February 1996 and August 1999 . INTERVENTION Volunteers were recruited from the community and trained to implement a parenting curriculum during weekly home visits . Each volunteer was paired with one teenager . MAIN OUTCOME MEASURE Vali date d instruments measuring parenting stress , parenting behaviors , and mental health . RESULTS A total of 232 teenagers were successfully r and omized to home visitation and control groups . At baseline , the groups were comparable on demographic , social support , and mental health measures . Almost half the teenagers had poor mental health at baseline , and high rates persisted at follow-up in both groups . In multivariate models , the home visitation group demonstrated significantly better parenting behavior scores at follow-up than did the control group ( P = .01 ) but showed no differences in parenting stress or mental health . CONCLUSIONS The volunteer home visitation program significantly improved some parenting outcomes but not parental distress or poor mental health . Volunteers may be an effective means of providing parenting education , but interventions that include specific means of addressing poor mental health are likely to have greater effects Mental health among university students represents an important and growing public health concern for which epidemiological data are needed . A Web-based survey was administered to a r and om sample at a large public university with a demographic profile similar to the national student population .  Depressive and anxiety disorders were assessed with the Patient Health Question naire ( R. L. Spitzer , K. Kroenke , J. B. W. Williams , & the Patient Health Question naire Primary Care Study Group , 1999 ) . Nonresponse weights were constructed with administrative data and a brief non-respondent survey . The response rate was 56.6 % ( N = 2,843 ) . The estimated prevalence of any depressive or anxiety disorder was 15.6 % for undergraduates and 13.0 % for graduate students .  Suicidal ideation in the past 4 weeks was reported by 2 % of students . Students reporting financial struggles were at higher risk for mental health problems ( odds ratios = 1.6 - 9.0 ) . These findings highlight the need to address mental health in young adult population s , particularly among those of lower socioeconomic status . Campus communities reach over half of young adults and thus represent unique opportunities to address mental health issues in this important age group OBJECTIVES This study evaluated an intervention design ed to improve behavioral and mental health outcomes among adolescents and their parents with AIDS . METHODS Parents with AIDS ( n = 307 ) and their adolescent children ( n = 412 ) were r and omly assigned to an intensive intervention or a st and ard care control condition . Ninety-five percent of subjects were reassessed at least once annually over 2 years . RESULTS Adolescents in the intensive intervention condition reported significantly lower levels of emotional distress , of multiple problem behaviors , of conduct problems , and of family-related stressors and higher levels of self-esteem than adolescents in the st and ard care condition . Parents with AIDS in the intervention condition also reported significantly lower levels of emotional distress and multiple problem behaviors . Coping style , levels of disclosure regarding serostatus , and formation of legal custody plans were similar across intervention conditions . CONCLUSIONS Interventions can reduce the long-term impact of  parents ' HIV status on themselves and their children PURPOSE Adolescent mothers are at risk for rapidly becoming pregnant again and for depression , school dropout , and poor parenting . We evaluated the impact of a community-based home-visiting program on these outcomes and on linking the adolescents with primary care . METHODS Pregnant adolescents aged 12 to 18 years , predominantly with low incomes and of African American race , were recruited from urban prenatal care sites and r and omly assigned to home visiting or usual care .  Trained home visitors , recruited from local communities , were paired with each adolescent and provided services through the child ’s second birthday . They delivered a parenting curriculum , encouraged contraceptive use , connected the teen with primary care , and promoted school continuation . Research assistants collected data via structured interviews at baseline and at 1 and 2 years of follow-up using vali date d instruments to measure parenting ( Adult-Adolescent Parenting Inventory ) and depression ( Center for Epidemiologic Studies Depression ) . School status and repeat pregnancy were self-reported . We measured program impact over time with intention-to-treat analyses using generalized estimating equations ( GEE ) . RESULTS Of 122 eligible pregnant adolescents , 84 consented , completed baseline assessment s , and were r and omized to a home-visited group ( n = 44 ) or a control group ( n = 40 ) . Eighty-three percent completed year 1 or year 2 follow-up assessment s , or both . With GEE , controlling for baseline differences , follow-up parenting scores for home-visited teens were 5.5 points higher than those for control teens ( 95 % confidence interval , 0.5–10.4 points ; P = .03 ) and their adjusted odds of school continuation were 3.5 times greater ( 95 % confidence interval , 1.1–11.8 ; P < .05 ) . The program did not have any impact on repeat pregnancy , depression , or linkage with primary care . CONCLUSIONS This community-based home-visiting program improved  adolescent mothers ’ parenting attitudes and school continuation , but it did not reduce their odds of repeat pregnancy or depression or achieve coordination with primary care . Coordinated care may require explicit mechanisms to promote communication between the community program and primary care This study examined whether after 20 sessions over 10 weeks of Jacobson 's muscle relaxation accompanied by encouragement of positive self-esteem academic examination scores of 22 undergraduate college students would improve by comparison with those of a control group of 30 students . The relaxation group had significantly higher examination grade s than the control group , but there was no significant mean difference between the groups on the Cattell and Scheier Anxiety Scale or a two-item measure of self-esteem Conclusion We have illustrated how our “ small theory ” ( Lipsey , 1990 ) of bereavement guided the development and evaluation of a preventive intervention for bereaved children . Our small theory , based on prior empirical research , enabled us to identify family processes that appeared to mediate the effects of parental death on child mental health .  Our intervention was design ed to attempt to change these processes . The evaluation of our experimental trial of the intervention assessed changes on these processes as well as the more distal mental health outcomes . The experimental trial showed some-what encouraging results , in terms of the program 's ability to modify the warmth of the parent – child relationship and to decrease symptomatology in the adolescent children . We also obtained further empirical support for our underlying theoretical model . Finally , implication s for re design 
    Output:
    
Cognitive behavioral therapy programs were more common than other interventions and were consistently found to lower symptoms or prevent depression or anxiety .
Automated or computerized interventions showed promise , with 60 % of anxiety programs and 83 % of depression programs yielding successful outcomes on at least one measure .