***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: BACKGROUND The effectiveness of post-deployment screening for mental disorders has not been assessed in a r and omised controlled trial . We aim ed to assess whether post-deployment screening for post-traumatic stress disorder ( PTSD ) , depression , anxiety , or alcohol misuse was effective . We defined screening as the presumptive identification of a previously unrecognised disorder using tests to distinguish those who probably had the disorder from those who probably did not so that those people with a probable disorder could be referred appropriately , and assessed effectiveness and consequences for help-seeking by the odds ratio at follow-up between those receiving tailored help-seeking advice and those who received general mental health advice . METHODS We did a cluster r and omised controlled trial among Royal Marines and Army personnel in the UK military after deployment to Afghanistan . Platoons were r and omly assigned ( 1:1 initially , then 2:1 ) by stratified block r and omisation with r and omly varying block sizes of two and four to the screening group , which received tailored help-seeking advice , or the control group , which received general mental health advice . Initial assessment took place 6 - 12 weeks after deployment ; follow-up assessment s were done 10 - 24 months later . Follow-up measures were the PTSD Checklist-Civilian Version , Patient Health Question naire-9 , Generalised Anxiety Disorder-7 scale , Alcohol Use Disorder Identification Test ( AUDIT ) , and self-reported help-seeking from clinical and welfare providers comparing those receiving tailored advice and those receiving only general advice . All participants and all investigators other than the person who analysed the data were masked to allocation . The primary outcomes were PTSD , depression or generalised anxiety disorder , and alcohol misuse at follow-up . A key secondary outcome was assessment of whether post-deployment  screening followed by tailored advice would modify help-seeking behaviour . Comparisons were made between screening and control groups , with primary analyses by intention to treat . This trial is registered with the IS RCT N Registry , number IS RCT N19965528 . FINDINGS Between Oct 24 , 2011 , and Oct 31 , 2014 , 434 platoons comprising 10 190 personnel were included : 274 ( 6350 personnel ) in the screening group and 160 ( 3840 personnel ) in the control group . 5577 ( 88 % ) of 6350 personnel received screening and 3996 ( 63 % ) completed follow-up , whereas 3149 ( 82 % ) of 3840 received the control question naire and 2369 ( 62 % ) completed follow-up . 1958 ( 35 % ) of 5577 personnel in the screening group declined to see the tailored advice , but those with PTSD ( 83 % ) or anxiety or depression ( 84 % ) were more likely than non-cases ( 64 % ) to view the advice ( both p<0·0001 ) . At follow-up , there were no significant differences in prevalence between groups for PTSD ( adjusted odds ratio 0·92 , 95 % CI 0·75 - 1·14 ) , depression or anxiety ( 0·91 , 0·71 - 1·16 ) , alcohol misuse ( 0·88 , 0·73 - 1·06 ) , or seeking support for mental disorders ( 0·92 , 0·78 - 1·08 ) . INTERPRETATION Post-deployment screening for mental disorders based on tailored advice was not effective at reducing prevalence of mental health disorders nor did it increase help-seeking . Countries that have implemented post-deployment screening programmes for mental disorders should consider monitoring the outcomes of their programmes . FUNDING The US Army Medical Research and Materiel Comm and -Military Operational Medicine Research Program ( USAMRMC-MOMRP ) Acceptance and commitment therapy ( ACT ) has previously been shown to alter stigmatizing attitudes and to be relatively useful for psychologically inflexible participants . The present study is the first to bring those two findings together by comparing ACT to an education intervention for reducing stigma toward people with psychological disorders , and examining whether results differ for psychologically inflexible versus flexible individuals . A sample of college students ( N = 95 ) was r and omly assigned to a 2(1)2h ACT or educational workshop . Measures were taken before and after the workshop and at a 1-month follow-up . ACT reduced mental health stigma significantly regardless of participants ' pre-treatment levels of psychological flexibility , but education reduced stigma only among participants who were relatively flexible and non-avoidant to begin with . Acceptance could be an important avenue of exploration for stigma research ers This article reports pilot data from phase I of a project to develop and evaluate a self-directed program of integrative therapies for National Guard personnel and significant relationship partners to support reintegration and resilience after return from Iraq or Afghanistan . Data are reported on 43 dyads . Intervention was an integrated multimedia package of guided meditative , contemplative , and relaxation exercises ( CD ) and instruction in simple massage techniques ( DVD ) to promote stress reduction and interpersonal connectedness . A repeated measures design with st and ardized instruments was used to establish stability of baseline levels of relevant mental health domains ( day 1 , day 30 ) , followed by the intervention and assessment s 4 and 8 weeks later . Significant improvements in st and ardized measures for post-traumatic stress disorder , depression , and self-compassion were seen in both veterans and partners ; and in stress for partners . Weekly online reporting tracked utilization of guided exercises and massage . Veterans reported significant reductions in ratings of physical pain , physical tension , irritability , anxiety/worry , and depression after massage , and longitudinal analysis suggested declining baseline levels of tension and irritability . Qualitative data from focus groups and implication s for continued development and a phase II trial are discussed Background : Many veterans deployed after 9/11/2001 are impacted by subthreshold levels of post-traumatic stress , anxiety , or other psychological health problems that may interfere with successful reintegration . Conventional treatments , including medication and trauma-focused individual psychotherapies , may not be optimally adapted , accepted , or effective to treat these subsyndromal symptoms . Methods : We developed “ Resilient Warrior , ” a 4-session , group-based , mind-body stress-management and resilience program targeted to build skills and assessed whether its format was accessible and acceptable , and potentially efficacious , to support resilience among service members . Results : From April 2014 to October 2014 , 15 participants ( 53.3 % women ; mean age=36.6 y ; SD=6.2 ) were surveyed for program acceptability and feasibility and completed self-reported psychological health outcomes before and after program participation . The majority ( 71.4 % ) of participants reported that the program included the right number of sessions , and all of them reported that it was helpful and relevant and that they would recommend it to others . While changes in self-reported resilience were only marginal , participation was associated with improvements in depressive symptoms , perceived stress , anxiety , and general sense of self efficacy . Conclusion : These pilot data provide preliminary support that “ Resilient Warrior , ” a group-based , stress reduction and resilience program , may improve psychological health in service members even when delivered in community setting s. R and omized controlled trials with longer follow-up periods are needed to establish efficacy and effectiveness for this program OBJECTIVE Anger and aggression are serious problems for a significant proportion of veterans who have served in combat . While prior research has suggested that cognitive behavioral treatments may be effective for anger problems , there are few controlled studies of anger treatment in veterans and no studies of anger treatment focusing exclusively on veterans from the Iraq and Afghanistan wars . This r and omized pilot study compared an adapted cognitive behavioral intervention ( CBI ) to a supportive intervention ( SI ) control condition for the treatment of anger problems in veterans returning from deployment in Iraq or Afghanistan . METHODS 25 veterans with warzone trauma , problems with anger , and one or more additional hyperarousal symptoms were r and omized and 23 started treatment ( CBI  , n = 12 ; SI , n = 11 ) . Outcome measures were administered at pre- and post- treatment and at 3 months post-treatment . RESULTS CBI was associated with significantly more improvement than SI on measures of anger and interpersonal functioning . Gains were maintained at follow-up . CONCLUSIONS Findings suggest that CBI may be more effective than an active control providing psychoeducation , relaxation , and supportive therapy for treating anger problems in returning veterans . The findings need to be replicated in an adequately powered and more diverse sample The decade long conflicts in Iraq and Afghanistan have placed considerable strain on military families . Given robust data showing high rates of deployment-related psychological health problems in spouses and children , and the near absence of evidence -based psychological health programs for military families in the community , interventions are urgently needed to support and strengthen spouses as they adjust to deployment transitions and military life experiences . This Phase 1 pilot study evaluated the feasibility and acceptability of a resiliency intervention for military spouses in civilian communities ( HomeFront Strong ; HFS ) , and generated preliminary efficacy data regarding impacts on psychological health and adjustment . Through two group cohorts , 14 women completed the intervention , with 10 women providing pre- and postgroup assessment data . Findings support feasibility of the intervention and high rates of program satisfaction . Participants reported learning new strategies and feeling more knowledgeable in their ability to use effective coping skills for managing deployment and military-related stressors . Participation in HFS was also associated with reduction in levels of anxiety and perceived stress , and improvements in life satisfaction and life engagement .  HFS is a promising community-based intervention for military spouses design ed to enhance resiliency , reduce negative psychological health symptoms , and improve coping BACKGROUND The Cochrane Collaboration is strongly encouraging the use of a newly developed tool , the Cochrane Collaboration Risk of Bias Tool ( CCRBT ) , for all review groups . However , the psychometric properties of this tool to date have yet to be described . Thus , the objective of this study was to add information about psychometric properties of the CCRBT including inter-rater reliability and concurrent validity , in comparison with the Effective Public Health Practice Project Quality Assessment Tool ( EPHPP ) . METHODS Both tools were used to assess the method ological quality of 20 r and omized controlled trials included in our systematic review of the effectiveness of knowledge translation interventions  to improve the management of cancer pain . Each study assessment was completed independently by two review ers using each tool . We analysed the inter-rater reliability of each tool 's individual domains , as well as final grade assigned to each study . RESULTS The EPHPP had fair inter-rater agreement for individual domains and excellent agreement for the final grade . In contrast , the CCRBT had slight inter-rater agreement for individual domains and fair inter-rater agreement for final grade . Of interest , no agreement between the two tools was evident in their final grade assigned to each study . Although both tools were developed to assess ' quality of the evidence ' , they appear to measure different constructs . CONCLUSIONS Both tools performed quite differently when evaluating the risk of bias or method ological quality of studies in knowledge translation interventions for cancer pain . The newly introduced CCRBT assigned these studies a higher risk of bias . Its psychometric properties need to be more thoroughly vali date d , in a range of research fields , to underst and fully how to interpret results from its application Background Veterans with history of deployment in the Global War on Terror face significant and ongoing challenges with high prevalences of adverse psychological , physical , spiritual , and family impacts . Together , these challenges contribute to an emerging public health crisis likely to extend well into the future . Innovative approaches are needed that reach veterans and their family members with strategies they can employ over time in their daily lives to promote improved adjustment and well-being . Objective The objective of this study was to evaluate effects of use of a Web-based , self-directed program of instruction in mind- and body-based wellness skills to be employed by Global War on Terror veterans and their significant relationship partners on mental health and wellness outcomes associated with postdeployment readjustment . Methods We recruited 160 veteran-partner dyads in 4 regions of the United States ( San Diego , CA ; Dallas , TX ; Fayetteville , NC ; and New York , NY ) through publicity by the Iraq and Afghanistan Veterans of America to its membership . Dyads were r and omly allocated to 1 of 4 study arms : Mission Reconnect ( MR ) program alone , MR plus the Prevention and Relationship Enhancement Program ( PREP ) for Strong Bonds weekend program for military couples , PREP alone , and waitlist control . We administered a battery of st and ardized and investigator-generated instruments assessing mental health outcomes at baseline , 8 weeks , and 16 weeks . Dyads in the MR arms were provided Web-based and mobile app video and audio instruction in a set of mindfulness-related stress reduction and contemplative practice s , as well as partner massage for reciprocal use . All participants provided weekly reports on frequency and duration of self-care practice s for the first 8 weeks , and at 16 weeks . Results During the first 8-week reporting period , veterans and partners assigned to MR arms used some aspect of the program a mean of 20 times per week , totaling nearly 2.5 hours per week , with only modest declines in use at 16 weeks . Significant improvements were seen at 8 and 16 weeks in measures of posttraumatic stress disorder , depression , sleep quality , perceived stress , resilience , self-compassion , and pain for participants assigned to MR arms . In addition , significant reductions in self-reported levels of pain , tension , irritability , anxiety , and depression were associated with use of partner massage . Conclusions Both veterans and partners were able to learn and make sustained use of a range of wellness practice s taught in the MR program . Home-based , self-directed inter 
    Output:
    
Interventions had some significant positive effects mostly for veterans adjusting to civilian life and other family members .