***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: Reports of cluster r and omised trials require additional information to allow readers to interpret them accurately The effective reporting of r and omised controlled trials has received useful attention in recent years . Many journals now require that reports conform to the guidelines in the Consoli date d St and ards of Reporting Trials ( CONSORT ) statement , first published in 1996 and revised in 2001 . The statement includes a checklist of items that should be included in the trial report . These items are evidence based whenever possible and are regularly review ed . The statement also recommends including a flow diagram to show the flow of participants from group assignment through to the final analysis . The CONSORT statement focused on reporting parallel group r and omised trials in which individual participants are r and omly assigned to study groups . However , in some situations it is preferable to r and omly assign groups of individuals ( such as families or medical practice s ) rather than individuals . Reasons include the threat of contamination of some interventions ( such as dietary interventions ) if individual r and omisation is used . 5 Also , in certain setting s r and omisation by group may be the only feasible method of conducting a trial . Trials with this design are variously known as field trials , community based trials , place based trials , or ( as in this paper ) cluster r and omised trials . In an earlier discussion paper we considered the implication s of the CONSORT statement for the reporting of cluster r and omised trials . Here we present up date d guidance , based on the 2001 revision of the CONSORT statement This article describes and evaluates a K-6 child sexual abuse prevention curriculum that was piloted in a large northwestern school district 1986–89 . Paired t-tests using pre-test and post-test scores from a r and om sample of 1,391 K-6 students indicates that significant learning occurred at all grade levels . Analysis of variance results suggest that , overall , learning is not related to students ' gender or to the school 's socioeconomic level . Responses by 197 teachers concerning their  evaluations of curriculum material s and training were positive . Study limitations and future research plans and needs are discussed The authors evaluated a coeducational program for teenagers on preventing sexual coercion in dating situations . Students examined individual and social attitudes underlying coercive sexual behavior and learned communication skills aim ed at preventing or dealing with unwanted sexual advances . Instruction was enhanced by video and an interactive video " virtual date . " Outcomes were assessed using sexual attitude scales with a sample of 458 high school students . Student health education classes were r and omly assigned to either a treatment or a control condition . Findings , based on a latent variable model of differential effectiveness , showed that students in the treatment group with initial coercive attitude scores at or above the mean benefited significantly more than students with the same range of scores in the control group This paper reports the outcome of an attempt to teach children in grade s 5 and 6 about child abuse and neglect . The Child Abuse Component of the Human Relations Program described and evaluated here is a unique effort to provide children with an opportunity to discuss and learn about this aspect of family violence . An impact assessment was conducted by documenting possible changes in student knowledge and attitudes regarding child abuse as a result of exposure to the Child Abuse Component of the Human Relations Program . The test group of children consisted of 315 boys and girls in grade s 5 and 6 . A comparison group of 298 children was closely matched with the test group on the basis of age and sex . These groups were formed by r and omly selecting 12 teachers from all teachers agreeing to use the Component and 10 teachers choosing not to employ the Component . The students in the classrooms of these teachers received the same curriculum for their grade level with the exception of the field-test group additionally receiving the Component . Selected child abuse knowledge , attitude , and personality ( security ) measures were given all subjects in a post-test with comparison group research design . Teacher knowledge and attitude were also assessed . The results of the data analysis , teacher , and special observer reports suggest that the Component was effective in meeting its objectives and was not disturbing to test subjects . Apparently , the test children profited by experiencing the Component mainly because of the opportunity it provided for class discussion . Moreover , the knowledge levels and interest of the children in both groups was seriously underestimated Young children ( ages 4 and 5 ) and school-aged children ( 6 to 10 ) from a day-care center were r and omly assigned to a sexual abuse prevention training group and a wait-list control group . Children in the prevention training group were exposed to a three-hour program teaching common sexual abuse prevention concepts ( e.g. , the difference between OK and not-OK touches ) . Children in both groups were given a  structured interview  before and after the prevention group received training . Results of a repeated measures multivariate analysis of variance indicate that children in the prevention training group significantly increased their knowledge of prevention concepts while children in the control group did not . Older children  learned more than younger children . Both younger and older children had greater difficulty learning prevention concepts of an abstract nature than concepts of a specific nature OBJECTIVES This study assessed the effects of the Safe Date s program on the primary and secondary prevention of  adolescent dating violence .  METHODS Fourteen schools were r and omly allocated to treatment conditions .  Eighty percent ( n=1886 ) of the eighth and ninth grade rs in a rural county completed baseline question naires , and 1700 ( 90 % ) completed follow-up question naires . RESULTS Treatment and control groups were comparable at baseline . In the full sample at follow-up , less psychological abuse , sexual violence , and violence perpetrated against the current dating partner were reported in treatment than in control schools . In a sub sample of adolescents reporting no dating violence at baseline ( a primary prevention sub sample ) , there was less initiation of psychological abuse in treatment than in control schools . In a sub sample of adolescents reporting dating violence at baseline ( a secondary prevention sub sample ) , there was less psychological abuse and sexual violence perpetration reported at follow-up in treatment than in control schools . Most program effects were explained by changes in dating violence norms , gender stereotyping , and awareness of services . CONCLUSIONS The Safe Date s program shows promise for preventing dating violence among adolescents OBJECTIVE The research evaluated a sexual abuse prevention program for elementary school-aged children . Although other evaluations of similar programs have demonstrated significant improvements in knowledge and skills , a number of key questions with respect to their efficacy remain . METHOD 231 children were r and omly assigned ( matched by age ) to participate in the program ( N = 117 ) or in a wait-list control condition ( N = 114 ) . Knowledge of abuse prevention concepts were tested using the 33-item Children 's Knowledge of Abuse Question naire-Revised ( CKAQ-R ) , a st and ardized measure with strong psychometric properties ( Tutty , 1995 ) , with a new subscale on Appropriate Touch . RESULTS An analysis of covariance showed that children who received the program increased their knowledge levels of both Inappropriate Touch ( p = .000 ) and Appropriate Touch ( p = .012 ) to a significantly greater degree than children in the control group . Age also significantly differentiated the knowledge levels regarding Inappropriate Touch , with younger children knowing fewer concepts both at pretest and posttest ( p = .000 ) . Parallel results apply to the Appropriate Touch subscale ( p = .04 ) . CONCLUSIONS The results are consistent with other evaluations of child sexual abuse prevention programs , however the statistically significant though small gains suggest that the programs need to be presented in a more powerful manner OBJECTIVE The purpose of this study was to describe the extent to which childhood abuse and neglect increase a person 's risk for subsequent  posttraumatic stress disorder ( PTSD ) and to determine whether the relationship to PTSD persists despite controls for family , individual , and lifestyle characteristics associated with both childhood victimization and PTSD . METHOD Victims of substantiated child abuse and neglect from 1967 to 1971 in a Midwestern metropolitan county area were matched on the basis of age , race , sex , and approximate family socioeconomic class with a group of nonabused and nonneglected children and followed prospect ively into young adulthood . Subjects ( N = 1,196 ) were located and administered a 2-hour interview that included the National Institute of Mental Health Diagnostic Interview Schedule to assess PTSD . RESULTS Childhood victimization was associated with increased risk for lifetime and current PTSD . Slightly more than a third of the childhood victims of sexual abuse ( 37.5 % ) , 32.7 % of those physically abused , and 30.6 % of victims of childhood neglect met DSM-III-R criteria for lifetime PTSD . The relationship between childhood victimization and number of PTSD symptoms persisted despite the introduction of covariates associated with risk for both . CONCLUSIONS Victims of child abuse ( sexual and physical ) and neglect are at increased risk for developing PTSD , but childhood victimization is not a sufficient condition . Family , individual , and lifestyle variables also place individuals at risk and contribute to the symptoms of PTSD This paper presents results from a third grade sexual abuse prevention program . A 24-item question naire was administered as a pretest and post-test to an  experimental group ( n = 236 ) and a control group ( n = 195 ) of third grade students . Those receiving the sexual abuse prevention program significantly increased their sexual abuse knowledge scores from pretest to post-test . In addition , differences in knowledge were significantly higher in the experimental compared to the control group . Students who received the sexual abuse curriculum  significantly improved from pretest to post-test on their behavioral intention scores . Results from this evaluation indicated a modest improvement can be obtained through use of this two-hour sexual abuse prevention curriculum We compared the relative effectiveness of two educational approaches for teaching personal safety skills with 100 preschoolers . A behavioral skills training program was compared with a feelings-based program , which instructs children to trust their feelings when making safety decisions . Children 's abilities to discriminate between appropriate- and inappropriate-touch requests , their prevention skills , and levels of emotional distress were assessed before , immediately , and one month after program participation . Parents and teachers were surveyed regarding children 's reactions . Compared with a control presentation , both programs were effective in enhancing children 's knowledge and prevention skills without making them fearful , suggesting that preschool children can benefit from such programs . However , children in the feelings-based program had difficulty recognizing the appropriateness of certain touch requests , suggesting that this approach may have limited utility with preschool-age children Approximately 20 % of adolescents have experienced violence from a dating partner . The Safe Date s Project tests the effects of a program on the primary and secondary prevention of dating violence among adolescents living in a rural North Carolina county . The program being evaluated aims to prevent dating violence by changing dating violence norms , gender stereotyping , conflict-management skills , help-seeking , and cognitive factors associated with help-seeking . School activities include a theater production , a 10-session curriculum , and a poster contest . Community activities include special services for adolescents in violent relationships and community service provider training . A pretest-posttest experimental design with r and om allocation of 14 schools to treatment condition was used to test study hypotheses . Data were collected in schools using self-administered question naires . Eighty-one percent ( n = 1,967 ) of the eighth- and ninth- grade rs in the county completed baseline question naires , and 91 % of those adolescents completed follow-up question naires . The sample is 75.9 % Caucasian and 50.4 % female . Baseline data indicate that 25.4 % and 8.0 % of this sample have been victims of nonsexual and sexual dating violence , respectively , and 14.0 % and 2.0 % have been perpetrators of nonsexual and sexual dating violence , respectively . Consistent with other adolescent dating violence studies , both boys and girls report being victims and perpetrators of dating violence . Control and treatment groups are similar at baseline on all demographic , mediating , and outcome variables . Findings suggest that dating violence is prevalent among adolescents and that prevention programs are warranted We tested the prediction that a sexual abuse prevention program that included participant modeling ( PM ) would result in superior skill acquisition compared with a symbolic modeling ( SM ) program .  Twenty-six kindergarten children were assigned to one of the two programs after being matched for initial skill level . The PM program taught self-protective skills through modeling and active rehearsal ; the SM program taught the same skills , but the children watched as skills were modeled by the experimenter . Results provided evidence for the greater efficacy of PM relative to SM for the learning of personal safety skills and , thus , support the inclusion of active rehearsal in prevention programs for young children . In response to the high incidence of sexual abuse among children ( National Committee for the Prevention of Child Abuse , 1985 ) , many prevention programs aim ed at known-offende r abuse have been developed for implementation in school systems . As a result of their consistent and longitudinal contact with children and families , schools appear to be the most promising institution for the delivery of preventive instruction ( Brassard , Tyler , & Kehle , 1983 ) . A number of books , plays , films , small-group discussion s , and structured curricula are being promoted for school usage ( see review s by Conte , Rosen , & Saperstein , 1986 ; Wurtele , in press ) . Although school-based prevention programs have been widely implemented , little effort has been made to systematic all y evaluate what children learn and which teaching method is most effective or to determine if knowledge and skill gains are retained over time . Recently , we compared the effectiveness of the film " Touch " ( Illusion Theater Company & Media Ventures , 1984 ) with a control presentation ( Saslawsky & Wurtele , 1986 ) and , subsequently , with a multifaceted behavioral skills training ( BST ) package design ed to teach children self-protective skills ( Wurtele , Saslawsky , Miller , Marrs , & Britcher , 1986 ) . Results from this latter study indicated that children in the BST group OBJECTIVE To present accounts of the prevalence of childhood sexual abuse ( CSA ) and social , family , and related factors that are associated with increased risk of C 
    Output:
    
Studies evaluated in this review report significant improvements in knowledge measures and protective behaviours .