***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 
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    Input: BACKGROUND Unintentional injuries are the major cause of death among children , adolescents , and young adults . This article presents an evaluation of an injury-prevention program for 11- to 16-year-old , Hispanic migrant youth . DESIGN R and omized controlled trial with two conditions : first aid and home safety training and tobacco and alcohol prevention . Participants were assessed at baseline , at immediate post-intervention , and at 1-year follow-up . PARTICIPANTS A total of 660 Hispanic adolescent and parent pairs participated in a program entitled Sembr and o Salud ( sowing the seeds of health ) . INTERVENTION The intervention consisted of two conditions : first aid and home safety training and tobacco and alcohol prevention . Both groups were exposed to an eight-session , multimedia program presented by bilingual , bicultural college students . The sessions consisted of lectures , discussion s , and skills development and practice . OUTCOME MEASURES To examine the efficacy of the first aid and home safety intervention , adolescents were assessed for changes in first aid confidence , knowledge of items in a first aid kit , knowledge of how to respond in an emergency situation , acquisition of a first aid kit , and behavioral skills testing in response to two emergency scenarios . RESULTS Similar changes in confidence were observed in both groups after the intervention . Participants in the first aid and home safety program were better able to identify items to include in a first aid kit , how to respond in an emergency situation , and reported fewer erroneous victim-caring procedures than the tobacco and alcohol prevention group . CONCLUSIONS Sembr and o Salud was successful at achieving and maintaining change in confidence and knowledge of first aid and emergency response skills over a yearlong period Abstract Objective : To measure the effect of giving out free smoke alarms on rates of fires and rates of fire related injury in a deprived multiethnic urban population . Design : Cluster r and omised controlled trial . Setting : Forty electoral wards in two boroughs of inner London , United Kingdom . Participants : Primarily households including elderly people or children and households that are in housing rented from the borough council . Intervention : 20 050 smoke alarms , fittings , and educational brochures distributed free and installed on request . Main outcome measures : Rates of fires and related injuries during two years after the distribution ; alarm ownership , installation , and function . Results : Giving out free smoke alarms did not reduce injuries related to fire ( rate ratio 1.3 ; 95 % confidence interval 0.9 to 1.9 ) , admissions to hospital and deaths ( 1.3 ; 0.7 to 2.3 ) , or fires attended by the fire brigade ( 1.1 ; 0.96 to 1.3 ) . Similar proportions of intervention and control households had installed alarms ( 36/119 ( 30 % ) v 35/109 ( 32 % ) ; odds ratio 0.9 ; 95 % confidence interval 0.5 to 1.7 ) and working alarms ( 19/118 ( 16 % ) v 18/108 ( 17 % ) ; 0.9 ; 0.4 to 1.8 ) . Conclusions : Giving out free smoke alarms in a deprived , multiethnic , urban community did not reduce injuries related to fire , mostly because few alarms had been installed or were maintained . What is already known on this topic In the United Kingdom , residential fires caused 466 deaths and 14 600 non-fatal injuries in 1999 The risk of death from fire is associated with socioeconomic class One study reported an 80 % decline in hospitalisations and deaths from residential fires after free smoke alarms were distributed in an area at high risk , but these results may not apply in other setting s , and evidence from r and omised controlled trials is lacking What this study adds Giving out free smoke alarms in a multiethnic poor urban population did not reduce injuries related to fire or fires Giving smoke alarms away may be a waste of re sources and of little benefit unless alarm installation and maintenance is Objectives —To reduce fires and fire related injuries by increasing the prevalence of functioning smoke alarms in high risk households . Setting —The programme was delivered in an inner London area with above average material deprivation and below average smoke alarm ownership . The target population included low income and rental households and households with elderly persons or young children . Methods —Forty wards , averaging 4000 households each , were r and omised to intervention or control status . Free smoke alarms and fire safety information were distributed in intervention wards by community groups and workers as part of routine activities and by paid workers who visited target neighbourhoods . Recipients provided data on household age distribution and housing tenure . Programme costs were documented from a societal perspective . Data are being collected on smoke alarm ownership and function , and on fires and related injuries and their costs . Results —Community and paid workers distributed 20 050 smoke alarms , potentially sufficient to increase smoke alarm ownership by 50 % in intervention wards . Compared with the total study population , recipients included greater proportions of low income and rental households and households including children under 5 years or adults aged 65 and older .  Total programme costs were £ 145 087 . Conclusions —It is possible to implement a large scale smoke alarm giveaway programme targeted to high risk households in a densely populated , multicultural , material ly deprived community . The programme 's effects on the prevalence of installed and functioning alarms and the incidence of fires and fire related injuries , and its cost effectiveness , are being evaluated as a r and omised controlled trial Abstract Objectives : To identify which type of smoke alarm is most likely to remain working in local authority inner city housing , and to identify an alarm tolerated in households with smokers . Design : R and omised controlled trial . Setting : Two local authority housing estates in inner London . Participants : 2145 households . Intervention : Installation of one of five types of smoke alarm ( ionisation sensor with a zinc battery ; ionisation sensor with a zinc battery and pause button ; ionisation sensor with a lithium battery and pause button ; optical sensor with a lithium battery ; or optical sensor with a zinc battery ) . Main outcome measure : Percentage of homes with any working alarm and percentage in which the alarm installed for this study was working after 15 months . Results : 54.4 % ( 1166/2145 ) of all households and 45.9 % ( 465/1012 ) of households occupied by smokers had a working smoke alarm . Ionisation sensor , lithium battery , and there being a smoker in the household were independently associated with whether an alarm was working ( adjusted odds ratios 2.24 ( 95 % confidence interval 1.75 to 2.87 ) , 2.20 ( 1.77 to 2.75 ) , and 0.62 ( 0.52 to 0.74 ) ) . The most common reasons for non-function were missing battery ( 19 % ) , missing alarm ( 17 % ) , and battery disconnected ( 4 % ) . Conclusions : Nearly half of the alarms installed were not working when tested 15 months later . Type of alarm and power source are important determinants of whether a household had a working alarm . What is already known on this topic Functioning smoke alarms can reduce the risk of death in the event of a house fire Many local authorities install smoke alarms in their properties Several different types of smoke alarm are available What this study adds Only half of the smoke alarms installed in local authority housing were still working 15 months later Ionising smoke alarms with long life lithium batteries were most likely to remain functioning Installing smoke alarms may not be an effective use of re Parents of 171 children coming to the Yale-New Haven Hospital Primary Care Center for their 6-month checkup were r and omized into an intervention group ( n = 85 ) and a  control  group ( n = 86 ) . Parents in the intervention group received a three-part individualized course in child safety that required active parental participation . Parts 1 , 2 , and 3 were given at the 6-month , 9-month , and 12-month well-child visits , respectively . Parents in the control group received routine safety education as provided at well-child visits . The educational phase of the study was completed by 129 families , 65 in the intervention group and 64 in the control group .  Safety knowledge , number of hazards in the home , and reported accidents were assessed by a " blinded " community health worker approximately 1 month after the 12-month well-child visit . A total of 109 home visits were made , 55 for the intervention group and 54 for the control group . Parental safety knowledge was assessed based upon pictorial hazard recognition . Of 13 possible hazards , the mean number of hazards recognized by the intervention group parents was 9.4 ( n = 55 ) v 8.4 ( n = 50 ) by the control group parents ( t = 2.1 , P less than .05 , two-tailed ) . A hazard score was determined for each family based on nine possible hazards observed at the home visit . The mean hazard score for the intervention group was 2.4 ( n = 55 v 3.0 ( n = 54 ) for the control group ( t = 2.4 , P less than .02 , two-tailed ) . Parentally reported accidents and accidents reported in hospital records were similar for both groups . Results of this study suggest that age-appropriate safety education that is repetitive and individualized and that requires active parental participation results in an increase in parental knowledge and an improvement in certain safety practice AIMS To assess the effect on health visitor action of providing community health visitors with information on all injury attendances in children under 5 attending an accident and emergency ( A&E ) department and of providing additional information about each injury . METHODS Children under 5 years attending the A&E department at Queen 's Medical Centre , Nottingham between October 1998 and April 1999 were studied , using a r and omised controlled trial with a 2 × 2 factorial design . All attendances or selected attendances ( all children under 1 , burns and scalds , poisonings , head injuries , and repeat attendances in preceding six months ) were notified . Provision of st and ard ( diagnosis , circumstances surrounding injury , and disposal ) or additional information ( st and ard information plus place of injury , number of A&E attendances for injury in previous year , and any information recorded about safety equipment ) was noted . RESULTS Many notifications ( 56 % ) do not result in any action . Health visitors were nearly twice as likely to take action of some kind and three times as likely to undertake a home visit on receipt of notifications for selected attendances than on those for all attendances . A greater number of actions per notification were taken on receipt of information about selected attendances . Providing additional information had little effect on the action taken . CONCLUSIONS A selective policy for notifying community health visitors of child injury attendances at A&E results in a greater proportion of attendances in which the health visitor takes action and in a greater number of actions per attendance being taken . The utility of notifying all injury attendances is question able , as many do not result in any action OBJECTIVE : To determine the prevalence of  smoke alarm  use among families with children and to identify household factors that predict the absence of a smoke alarm . DESIGN : Cross sectional analysis of data collected in the September and November 1995 Omnibus Survey , conducted by the Office of Population Censuses and Surveys in the UK . SUBJECTS : A r and om sample of British households . Interviews were completed with 4,043 householders . The response rate was 78 % . RESULTS : 29 % of British households do not have a smoke alarm and  smoke alarms  were absent in 20 % of households with children under 15 years . A smoke alarm was absent in 41 % of privately rented homes compared with 17 % of owner occupied homes . Living in private rental accommodation was the strongest household predictor of the absence of a smoke alarm ( odds ratio = 3.25 , 95 % confidence interval 1.94 to 5.42 ) . Householders who had heard of National Fire Safety Week or the TV smoke alarm advertising campaign were significantly more likely to have a smoke alarm . The apparent effect of these campaigns was greatest in families with children . CONCLUSIONS :  Smoke alarm use has continued to increase but a substantial proportion of British homes still do not have smoke alarms . Homes at greatest risk of residential fire are the least likely to have an alarm . Health professionals may be able to increase  smoke alarm use among families with children , by counselling families about the benefits of smoke alarms . They may also be effective in this regard by lobbying local councils , houseing associations , or private l and lords to install alarms in all properties and by advocating for national legislation CONTEXT Seventy percent of U.S. residential fire deaths occur in homes without a working smoke detector . To help prevent residential fire deaths , many programs have distributed or installed detectors in unprotected homes . Because persons receiving a detector may not install it and because detector batteries require annual replacement , the enduring effectiveness of these programs may be question ed . OBJECTIVE We evaluated the long-term functional status of smoke detectors distributed to high-risk households in eight areas of Minnesota , Cherokee County ( North Carolina ) , and Oklahoma City ( Oklahoma ) . DESIGN Cross-sectional . SETTING Home visits were made to check the detectors that were distributed 3 to 4 years earlier . PARTICIPANTS R and omly selected households from the three detector promotion programs . MAIN OUT-COME MEASURE : At least one working smoke detector . RESULTS Participation rates ranged from 72 % to 82 % . The percentage of evaluation households with at least one working detector ranged from 58 % in Oklahoma to 73 % in North Carolina . In 76 % of households with nonworking detectors , the batteries were either missing or disconnected . When batteries in nonworking detectors were replaced , 83 % of the detectors regained function . CONCLUSIONS Future programs should consider distributing detectors that do not require annual battery changes or find effective ways to ensure that batteries are routinely replaced . Programs should also provide each household with the number of detectors needed to meet the most current recommended st and ard of the National Fire Protection Agency . The evaluation 's participation rates support the practicality 
    Output:
    
REVIEW ER 'S CONCLUSIONS Counselling as part of child health surveillance may increase smoke alarm ownership and function , but its effects on injuries are unevaluated .