***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: STUDY OBJECTIVE We evaluate a computer-based intervention for screening and health promotion in the emergency department and determine its effect on patient recall of health advice . METHODS This controlled clinical trial , with alternating assignment of patients to a computer intervention ( prevention group ) or usual care , was conducted in a university hospital ED . The study group consisted of 542 adult patients with nonurgent conditions . The study intervention was a self-administered computer survey generating individualized health information . Outcome measures were ( 1 ) patient willingness to take a computerized health risk assessment , ( 2 ) disclosure of behavioral risk factors , ( 3 ) requests for health information , and ( 4 ) remembered health advice . RESULTS Eighty-nine percent ( 470/542 ) of eligible patients participated . Ninety percent were black . Eighty-five percent ( 210/248 ) of patients in the prevention group disclosed 1 or more major behavioral risk factors including current smoking ( 79/248 ; 32 % ) , untreated hypertension ( 28/248 ; 13 % ) , problem drinking ( 46/248 ; 19 % ) , use of street drugs ( 33/248 ; 13 % ) , major depression ( 87/248 ; 35 % ) , unsafe sexual behavior ( 84/248 ; 33 % ) , and several other injury-prone behaviors . Ninety-five percent of patients in the prevention group requested health information . On follow-up at 1 week , 62 % ( 133/216 ) of the prevention group patients compared with 27 % ( 48/180 ) of the control subjects remembered receiving advice on what they could do to improve their health ( relative risk 2.3 , 95 % confidence interval 1.77 to 3.01 ) . CONCLUSION Using a self-administered computer-based health risk assessment , the majority of patients in our urban ED disclosed important health risks and requested information . They were more likely than a control group to remember receiving advice on what they could do to improve their health . Computer methodology may enable physicians to use patient waiting time for health promotion and to target at-risk patients for specific interventions OBJECTIVE : To estimate the efficacy of a psycho-behavioral intervention in reducing intimate partner violence recurrence during pregnancy and postpartum and in improving birth outcomes in African-American women . METHODS : We conducted a r and omized controlled trial for which 1,044 women were recruited . Women were r and omly assigned to receive either intervention ( n=521 ) or usual care ( n=523 ) . Individually tailored counseling sessions were adapted from evidence -based interventions for intimate partner violence and other risks . Logistic regression was used to model intimate partner violence victimization recurrence and to predict minor , severe , physical , and sexual intimate partner violence . RESULTS : Women r and omly assigned to the intervention group were less likely to have recurrent episodes of intimate partner violence victimization ( odds ratio [ OR ] 0.48 , 95 % confidence interval [ CI ] 0.29–0.80 ) . Women with minor intimate partner violence were significantly less likely to experience further episodes during pregnancy ( OR 0.48 , 95 % CI 0.26–0.86 , OR 0.53 , 95 % CI 0.28–0.99 ) and postpartum ( OR 0.56 , 95 % CI 0.34–0.93 ) . Numbers needed to treat were 17 , 12 , and 22 , respectively , as compared with the usual care group . Women with severe intimate partner violence showed significantly reduced episodes postpartum ( OR 0.39 , 95 % CI 0.18–0.82 ) ; the number needed to treat was 27 . Women who experienced physical intimate partner violence showed significant reduction at the first follow-up ( OR 0.49 , 95 % CI 0.27–0.91 ) and postpartum ( OR 0.47 , 95 % CI 0.27–0.82 ) ; the numbers needed to treat were 18 and 20 , respectively . Women in the intervention group had significantly fewer very preterm neonates ( 1.5 % intervention group , 6.6 % usual care group ; P=.03 ) and an increased mean gestational age ( 38.2±3.3 intervention group , 36.9±5.9 usual care group ; P=.016 ) . CONCLUSION : A relatively brief intervention during pregnancy had discernible effects on intimate partner violence and pregnancy outcomes . Screening for intimate partner violence as well as other psychosocial and behavioral risks and incorporating similar interventions in prenatal care is strongly recommended . CLINICAL TRIAL REGISTRATION : Clinical Trials.gov , www . clinical trials.gov , NCT00381823 . LEVEL OF EVIDENCE : BACKGROUND Most clinicians have no training about domestic violence , fail to identify patients experiencing abuse , and are uncertain about management after disclosure . We tested the effectiveness of a programme of training and support in primary health-care practice s to increase identification of  women experiencing domestic violence  and their referral to specialist advocacy services . METHODS In this cluster r and omised controlled trial , we selected general practice s in two urban primary care trusts , Hackney ( London ) and Bristol , UK . Practice s in which investigators from this trial were employed or those who did not use electronic records were excluded . Practice s were stratified by proportion of female doctors , postgraduate training status , number of patients registered , and percentage of practice population on low incomes . Within every primary care trust area , we r and omised practice s with a computer-minimisation programme with a r and om component to intervention or control groups . The intervention programme included practice -based training sessions , a prompt within the medical record to ask about abuse , and a referral pathway to a named domestic violence advocate , who also delivered the training and further consultancy . The primary outcome was recorded referral of patients to domestic violence advocacy services . The prespecified secondary outcome was recorded identification of domestic violence in the electronic medical records of the general practice . Poisson regression analyses accounting for clustering were done for all practice s receiving the intervention . Practice staff and research associates were not masked and patients were not aware they were part of a study . This study is registered at Current Controlled Trials , IS RCT N74012786 . FINDINGS We r and omised 51 ( 61 % ) of 84 eligible general practice s in Hackney and Bristol . Of these , 24 received a training and support programme , 24 did not receive the programme , and three dropped out before the trial started . 1 year after the second training session , the 24 intervention practice s recorded 223 referrals of patients to advocacy and the 24 control practice s recorded 12 referrals ( adjusted intervention rate ratio 22·1 [ 95 % CI 11·5 - 42·4 ] ) . Intervention practice s recorded 641 disclosures of domestic violence and control practice s recorded 236 ( adjusted intervention rate ratio 3·1 [ 95 % CI 2·2 - 4·3 ) . No adverse events were recorded . INTERPRETATION A training and support programme targeted at primary care clinicians and administrative staff improved referral to specialist domestic violence agencies and recorded identification of women experiencing domestic violence . Our findings reduce the uncertainty about the benefit of training and support interventions in primary care setting s for domestic violence and show that screening of women patients for domestic violence is not a necessary condition for improved identification and referral to advocacy services . FUNDING Health Foundation Background Intimate partner violence ( IPV ) can result in significant harm to women and families and is especially prevalent when women are pregnant or recent mothers . Maternal and child health nurses ( MCHN ) in Victoria , Australia are community-based nurse/midwives who see over 95 % of all mothers with newborns . MCHN are in an ideal position to identify and support women experiencing IPV , or refer them to specialist family violence services . Evidence for IPV screening in primary health care is inconclusive to date . The Victorian government recently required nurses to screen all mothers when babies are four weeks old , offering an opportunity to examine the effectiveness of MCHN IPV screening practice s. This protocol describes the development and design of MOVE , a study to examine IPV screening effectiveness and the sustainability of screening practice . Methods / design MOVE is a cluster r and omised trial of a good practice model of MCHN IPV screening involving eight maternal and child health nurse teams in Melbourne , Victoria . Normalisation Process Theory ( NPT ) was incorporated into the design , implementation and evaluation of the MOVE trial to enhance and evaluate sustainability . Using NPT , the development stage combined participatory action research with intervention nurse teams and a systematic review of nurse IPV studies to develop an intervention model incorporating consensus guidelines , clinical pathway and strategies for individual nurses , their teams and family violence services . Following twelve months ’ implementation , primary outcomes assessed include IPV inquiry , IPV disclosure by women and referral using data from MCHN routine data collection and a survey to all women giving birth in the previous eight months . IPV will be measured using the Composite Abuse Scale . Process and impact evaluation data ( online surveys and key stakeholders interviews ) will highlight NPT concepts to enhance sustainability of IPV identification and referral . Data will be collected again in two years . Discussion MOVE will be the first r and omised trial to determine IPV screening effectiveness in a community based nurse setting and the first to examine sustainability of an IPV screening intervention . It will further inform the debate about the effectiveness of IPV screening and describe IPV prevalence in a community based post-partum and early infant population .Trial registration BACKGROUND Intimate partner violence ( IPV ) during pregnancy poses a significant health risk to the mother and developing fetus . Practice guidelines recommend that prenatal providers screen for and counsel their patients about IPV , yet many physicians express reluctance or discomfort regarding such discussion s. The Health in Pregnancy ( HIP ) computer program was design ed to improve prenatal providers ' counseling about behavioral risks . METHODS English-speaking women 18 years or older , less than 26-weeks pregnant , and receiving prenatal care at one of the five participating clinics in the San Francisco area , were r and omized in parallel groups in a controlled trial ( June 2006-present ; data analyzed June 2007 ) . Participants reporting one or more risks were r and omized to intervention or control in stratified blocks . Providers received summary " cueing sheets " alerting them to their patient 's risk(s ) and suggesting counseling statements . RESULTS Thirteen percent ( 37/286 ) of the sample reported current IPV . Provider cueing result ed in 85 % of the IPV-intervention group reporting discussion s with their provider , compared to 23.5 % of the control group ( p<0.001 ) . CONCLUSIONS IPV discussion s were influenced strongly by cueing providers . Provider cueing is an effective and appropriate adjunct to routine risk counseling in prenatal care Background Significant emphasis is currently placed on the need to enhance health care decision-making with research -derived evidence . While much has been written on specific strategies to enable these “ knowledge-to-action ” processes , there is less empirical evidence regarding what happens when knowledge translation ( KT ) processes do not proceed as planned . The present paper provides a KT case study using the area of health care screening for intimate partner violence ( IPV ) . Methods A modified citation analysis method was used , beginning with a comprehensive search ( August 2009 to October 2012 ) to capture scholarly and grey literature , and news reports citing a specific r and omized controlled trial published in a major medical journal on the effectiveness of screening women , in health care setting s , for exposure to IPV . Results of the search es were extracted , coded and analysed using a multi-step mixed qualitative and quantitative content analysis process . Results The trial was cited in 147 citations from 112 different sources in journal articles , commentaries , books , and government and news reports . The trial also formed part of the evidence base for several national-level practice guidelines and policy statements . The most common interpretations of the trial were “ no benefit of screening ” , “ no harms of screening ” , or both . Variation existed in how these findings were represented , ranging from summaries of the findings , to privileging one outcome over others , and to critical qualifications , especially with regard to method ological rigour of the trial . Of note , interpretations were not always internally consistent , with the same evidence used in sometimes contradictory ways within the same source . Conclusions Our findings provide empirical data on the malleability of “ evidence ” in knowledge translation processes , and its potential for multiple , often unanticipated , uses . They have implication s for underst and ing how research evidence is used and interpreted in policy and practice , particularly in contested knowledge areas Background Interventions to change practice patterns among health care professionals have had mixed success . We tested the effectiveness of a practice centered intervention to increase  screening for domestic violence in primary care practice s. Methods A multifaceted intervention was conducted among primary care practice in North Carolina . All practice s design ated two individuals to serve as domestic violence re sources persons , underwent initial training on screening for domestic violence , and participated in 3 lunch and learn sessions .  Within this framework , practice s selected the screening instrument , patient educational material , and content best suited for their environment . Effectiveness was evaluated using a pre/post cross-sectional telephone survey of a r and om selection of female patients from each practice . Results Seventeen practice s were recruited and fifteen completed the study .  Baseline screening for domestic violence was 16 % with a range of 2 % to 49 % . An absolute increase in screening of 10 % was achieved ( range of increase 0 to 22 % ) . After controlling for clustering by practice and other patient characteristics , female patients were 79 % more likely to have been screened after the intervention ( OR 1.79 , 95 % CI 1.43–2.23 ) . Conclusion An intervention that allowed practice s to tail 
    Output:
    
The evidence shows that screening increases the identification of  women experiencing IPV in healthcare setting s. Overall , however , rates were low relative to best estimates of prevalence of IPV in women seeking healthcare .
Pregnant women in antenatal setting s may be more likely to disclose IPV when screened , however , rigorous research is needed to confirm this .
There was no evidence of an effect for other outcomes ( referral , re-exposure to violence , health measures , lack of harm arising from screening ) .