***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 We investigated the results obtained with a basic cardiopulmonary resuscitation ( b-CPR ) program ( PROCES ) specifically design ed for secondary school students ( 14–16 years old ) and taught by emergency physicians . Methods We used a multiple-choice test with 20 questions ( 10 on theory and 10 on skills ) answered before and immediately after and 1 year after receiving the b-CPR course . Satisfactory learning was considered when at least 8 out of 10 skill questions were correctly answered . We investigated student variables associated with better immediate and deferred ( 1 year after ) PROCES performance . We compared the results with those obtained using a more st and ardized program to teach b-CPR to police cadets . Results We enrolled 600 high school students . PROCES achieved significant improvement in overall , theory and skill marks immediately after the course ( P<0.001 ) , with a significant decay in all of them 1 year after the course ( P<0.001 ) . Satisfactory learning was achieved by 57 % of school students immediately after PROCES and by 37 % when assessed 1 year later . Students without pending study subjects ( P=0.001 ) and those from private schools ( P<0.01 ) achieved significantly better performance immediately after PROCES and only female students achieved greater performance 1 year after the course ( P<0.05 ) . With respect to police cadets instructed through a st and ardized course , immediate satisfactory learning of school students was lower ( 79 vs. 57 % , respectively ; P<0.001 ) , whereas deferred satisfactory learning was higher ( 23 vs. 37 % , respectively ; P<0.05 ) . Conclusion Emergency physicians can satisfactorily instruct secondary school students in b-CPR using PROCES , and this specific program achieves a reasonable amount of satisfactory learning OBJECTIVE To evaluate a new , 1-h , condensed training programme to teach continuous chest compression cardiopulmonary resuscitation ( CCC-CPR ) and automated external defibrillator ( AED ) skills to a cohort of eight grade public school students . METHODS RESULTS Thirty-three eligible subjects completed the programme ; mean age 13.7 years ; 48.5 % female . Eight participants reported some prior training in CPR and AED use . Following initial training , 29/33 ( 87.8 % ) subjects demonstrated proficiency at CCC-CPR and AED application/operation  in a mock adult cardiac arrest scenario . At four-weeks , 28/33 ( 84.8 % ) subjects demonstrated skill retention in similar scenario testing . Subjects also showed improvement in written knowledge regarding AED use as shown by scores on an AHA based written exam ( 60.9 % versus 77.3 % ; p<0.001 ) . CONCLUSION With our focused , condensed training program , eighth grade public school students became proficient in  CCC-CPR and AED use . This is the first study to document the ability of middle school students to learn and retain  CCC-CPR and AED skills for adult sudden cardiac arrest victims with such a curriculum AIMS Evaluation of school pupils ' resuscitation performance after different types of training relative to the effects of training frequency ( annually vs. biannually ) , starting age ( 10 vs. 13 years ) and facilitator ( emergency physician vs. teacher ) . METHODS Prospect i ve longitudinal study investigating 433 pupils in training and control groups . Outcome criteria were chest compression depth , compression frequency , ventilation volume , ventilation frequency , self-image and theoretical knowledge . In the training groups , 251 pupils received training annually or biannually either from emergency physicians or CPR-trained teachers . The control group without any training consisted of 182 pupils . RESULTS Improvements in training vs. control groups were observed in chest compression depth ( 38 vs. 24 mm ) , compression frequency ( 74 vs. 42 min(-1 ) ) , ventilation volume ( 734 ml vs. 21 ml ) and ventilation frequency ( 9/min vs. 0/min ) . Numbers of correct answers in a written test improved by 20 % , vs. 5 % in the control group . Pupils starting at age 10 showed practical skills equivalent to those starting at age 13 . Theoretical knowledge was better in older pupils . Self-confidence grew in the training groups . Neither more frequent training nor training by emergency physicians led to better performance among the pupils . CONCLUSIONS Pupils starting at age 10 are able to learn cardiopulmonary resuscitation with one annual training course only . After a 60-min CPR-training up date , teachers are able to provide courses successfully . Early training reduces anxieties about making mistakes and markedly increases participants ' willingness to help . Courses almost doubled the confidence of pupils that what they had learned would enable them to save lives As part of a campaign aim ed at increasing first-aid knowledge and skills , a training program was introduced in Norwegian junior high schools in 1997/98 . The program comprised a textbook , a video and a teacher 's manual . A quasi-experimental design was applied to evaluate the effects . Data were collected by pre- and post-test question naires to 82 r and omly selected schools .  Indexes for knowledge of first aid , attitudes towards giving and learning first aid , self-efficacy , emotions connected with first-aid situations and intended behavior in situations requiring first-aid action were constructed . In the intention-to-treat analysis of these indexes , the difference between the intervention and control group was modest . A separate question naire filled in by the teachers showed a low degree of implementation of the program . When comparing those classes that really used the program with the control classes , significant differences were revealed in many of the variables . Both self-efficacy , emotions in situations requiring first-aid skills and attitudes toward giving and learning first aid were of importance for intended behavior OBJECTIVE AND METHODS A prospect i ve r and omised study on 70 volunteers without previous first aid education ( 42 males , 28 females , mean age 17 ) was performed to compare mouth-to-mouth ventilation ( MMV , n = 24 ) versus mouth-to-pocket-mask ventilation ( MPV , n = 25 ) and mouth-to-face-shield ventilation ( MFV , n = 21 ) , and to evaluate if an instruction period of 10 min would be sufficient to teach lay persons artificial ventilation . Every volunteer performed three ventilation series using a bench model of an unprotected airway . RESULTS MMV and MPV show higher mean tidal volume ( TV ) than MFV ( values of series 3 : 976 + /- 454 and 868 + /- 459 versus 604 + /- 328 ml , P = 0.002 and P = 0.025 , respectively ) . We found a higher inter-individual variation in TV than in previous studies ( P = 0.031 ) . The recommended TV of 700 - 1000 ml was reached in only 23 % , most frequently with MPV ( MMV 16.7 % , MPV 32 % , MFV 19 % ) but the difference was not significant ( P = 0.391 ) . However , we found a significantly higher percentage with a TV below 700 ml with MFV ( MMV 33.3 % , MPV 36 % , MFV 66.7 % P = 0.047 ) and a significantly higher percentage of TV exceeding 1000 ml with MMV ( MMV 50 % , MPV 32 % , MFV 14.3 % ) ( P = 0.039 ) . " Stomach " inflation was highest with MMV ( 79.2 % ) followed by MPV ( 52 % ) and MFV ( 42.9 % ) ( P = 0.034 ) . We found further differences between the sexes ; males produced a higher TV ( P = 0.003 ) and a higher percentage of stomach inflation ( P = 0.029 ) . CONCLUSION MPV showed the best ventilation quality . It result ed in a more adequate TV than MMV and MFV and lower stomach inflation than MMV . Only a relatively low percentage of ventilations were within the recommended range for TV and this may be related to the short training duration . We found different performances between the sexes , a high inter-individual variation and mainly a low ventilation quality . Therefore , further studies have to focus more on teaching duration , sex differences and ventilation quality OBJECTIVE To evaluate new instructional methods for teaching high school students cardiopulmonary resuscitation ( CPR ) and automated external defibrillator ( AED ) knowledge , actions and skills . METHODS We conducted a cluster-controlled trial of 3 instructional interventions among Seattle area high school students , with r and om allocation based on classrooms , during 2003 - 04 . We examined two new instructional methods : interactive-computer training and interactive-computer training plus instructor-led ( h and s-on ) practice , and compared them with traditional classroom instruction that included video , teacher demonstration and instructor-led ( h and s-on ) practice , and with a control group . We assessed CPR and AED knowledge , performance of key AED and CPR actions , and essential CPR ventilation and compressions skills 2 days and 2 months after training . All outcomes were transformed to a scale of 0 - 100 % . RESULTS For all outcome measures mean scores were higher in the instructional groups than in the control group . Two days after training all instructional groups had mean CPR and AED knowledge scores above 75 % , with use of the computer program scores were above 80 % . Mean scores for key AED actions were above 80 % for all groups with training , with h and s-on practice enhancing students ' positive outcomes for AED pad placement . Students who received h and s-on practice more successfully performed CPR actions than those in the computer program only group . In the 2 h and s-on practice groups the scores for 3 of the outcomes ranged from 57 to 74 % ; they were 32 to 54 % in the computer only group . For the outcome of continuing CPR until the AED was available scores were high , 89 to 100 % in all 3 training groups . Mean CPR skill scores were low in all groups . The highest mean score for successful ventilations was 15 % and for compressions , 29 % . The pattern of results was similar after 2 months . CONCLUSIONS We found evidence that interactive computer based self instruction alone was sufficient to teach CPR and AED knowledge and AED actions to high school students . All forms of instruction were highly effective in teaching AED use . In contrast to AED skills , CPR remains a set of difficult psychomotor skills that is challenging to teach to high school students as well as other members of the lay public Objective —To evaluate the effect of an injury prevention programme ( Injury Minimization Programme for Schools , IMPS ) on children 's primary and secondary prevention , and basic life support , knowledge , attitudes , skills , and behaviour . Design — Prospect i ve non-r and omised matched control . Setting —Radcliffe NHS Trust and primary and middle schools in Oxfordshire , UK . Subjects—1200 year 6 children ( 10 and 11 years old ) ; 600 received IMPS , a primary and secondary injury prevention programme taught in the school and hospital environments ; 600 children in the control group received no planned intervention .  Main outcome measures —Safety knowledge , measured using a quiz . Resuscitation skills and behaviour observed and assessed using a simulated emergency scenario . Attitude and hypothetical behaviour towards safety assessed by the “ draw and write ” technique . Results —Before intervention , both groups had similar levels of knowledge . Five months after the intervention , significantly more IMPS trained children demonstrated a greater increase in knowledge in administering first aid and the correct procedure for making a call to the emergency services . They also demonstrated better basic life support techniques — for example , mouth-to-mouth and cardiac compressions . They identified more subtle dangers , were more likely to seek help , and tell others that their behaviour was dangerous . Conclusion —The results demonstrate the benefits of the IMPS programme on injury prevention knowledge , attitudes , and behaviours The objective of this study was to test the feasibility of teaching secondary school students to perform cardiopulmonary resuscitation ( CPR ) according to National Research Council (NRC)—American Heart Association ( AHA ) st and ards . Criterion levels specified by AHA call for cardiac compression at a rate of 60 times a minute with two ventilations interposed after 15 cardiac compressions . Translated into numerical performance per minute , this st and ard equates to 36 compressions and six ventilations per minute . Students were instructed by their usual teachers who received a special educational program in preparation . Both immediate learning and retention of the students after three months were evaluated using a practical and a written test . Teacher performance was evaluated by means of a practical test and a behavior rating . CPR is a motor task involving both continuous and discrete processes . Results of the study corresponded to analogous studies in the psychomotor literature : practice group students ' retention of continuous skills ( breaths and compressions ) was good ( little loss of skill ) , while retention of discrete motor skills ( open the airway , check vital signs ) was poor . Fifty-five per cent of the practice group in the initial test and 31 per cent in the retention study were able to perform the skills . Retention figures compare favorably with studies in the area of psychomotor learning . The study suggests that it is possible to train secondary school students to perform the ABC 's of CPR if they have an opportunity to practice these skills . The study also suggests that the teacher training is an important factor Background Most witnessed out-of-hospital cardiac arrests ( OHCA ) do not receive byst and er cardiopulmonary resuscitation ( CPR ) . The incidence of laypersonsO ' CPR could be increased by widespread training . We evaluated the effect of distribution of CPR educational material to high-school students in the area of Como , Italy . Methods and results From January 2008 to October 2009 , we distributed  3200 resuscitation manikins to pupils ( 62 % boys , mean age 16.5 ± 0.8 years ) at 20 high schools in the area of Como . All students received a kit including a personal manikin and a 27 min educational digital video 
    Output:
    
Evidence shows that cardiopulmonary training , delivered in various ways , is successful in a wide age range of children .
While older children perform more successfully on testing , younger children are able to perform basic tasks well , including use of AEDs .
Chest compression depth correlates with physical factors such as increasing weight , BMI and height .
Instruction must include h and s on practice to enable children to perform physical tasks .
Repeated training improves performance and retention but the format and frequency of repeated training is yet to be fully determined .