***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: This study examined the effectiveness of the universal component of the Fast Track prevention model : the PATHS ( Promoting Alternative THinking Strategies ) curriculum and teacher consultation . This r and omized clinical trial involved 198 intervention and 180 comparison classrooms from neighborhoods with greater than average crime in 4 U.S. locations . In the intervention schools , Grade 1 teachers delivered a 57-lesson social competence intervention focused on  self-control , emotional awareness , peer relations , and problem solving .  Findings indicated significant effects on peer ratings of aggression and hyperactive-disruptive behavior and observer ratings of classroom atmosphere . Quality of implementation predicted variation in assessment s of classroom functioning . The results are discussed in terms of both the efficacy of universal , school-based prevention models and the need to examine comprehensive , multiyear programs The influence of cognitive self-instructional training on the  impulsive-aggressive behavior of 16 third- grade boys was examined . Children were equated by ranks on the frequency of their aggressive and motor behavior in the classroom and r and omly assigned to the cognitive self-instruction or an attention-control group . The instruction condition employed a training procedure which required the child to talk to himself , initially overtly and then covertly , to increase self-control . Posttreatment classroom observations and teachers ' ratings showed that the instruction group exhibited fewer deviant behaviors compared to controls although the differences were non-significant . Daring a staged problematic situation the instruction condition showed somewhat fewer deviant responses than controls and the number of prosocial responses differed only slightly . However , there was a significant difference between groups in the frequency of waiting and verbal aggressive behaviors . Results suggest that the instruction group may have used covert speech for controlling deviant responses to frustration rather than generating prosocial approach behavior This study tested the hypothesis that both aggressive and withdrawn children would benefit from participating in brief daily learning sessions with peers having similar behavioral problems . In particular the study looked for gains in self-concept and in the  children 's behavioral difficulties . Sixty children from a Buffalo public school were r and omly placed into three groups : tutors , tutees , and control subjects . After r and om assignments were made , I met with the tutors for two training sessions in which they learned how to correct and reinforce their students in an easygoing , nonhostile manner . Tutors were given freedom to manipulate content material s of each session and were allowed to meet with their tutees as often as they wanted . After the five weeks of peer tutoring , almost all children who actively participated in the program showed higher gains than the control subjects . They had higher self-concepts and made greater behavioral improvements . In addition they demonstrated a renewed interest in school and in the learning process . A significant correlation was found between gain scores and the number of times of participation in the peer-tutoring sessions . Teachers and administrators were in favor of continuing the project with some modification . They felt that the sessions should be more structured and more under a teacher 's control A multiyear , multi context aggression prevention intervention was provided during the early or late elementary school years in an inner-city and an urban poor community . Sixteen schools were r and omly assigned to 1 of 4 conditions : ( a ) no-treatment control , ( b ) general enhancement classroom program , ( c ) general enhancement plus small-group peer-skills training , or ( d ) general enhancement plus small-group peer-skills training plus family intervention . This article reports on results for the high-risk sub sample of 1,500 children . Results from hierarchical linear modeling indicate that comprehensive interventions , if provided in early grade s , can be effective for children in schools in setting s with re sources adequate to support learning and development , but some unintended effects can occur in schools in the most distressed communities when delivered too late in development Annual screenings of preschool children at kindergarten registration identified 158 children having high levels of aggressive , hyperactive , impulsive , and inattentive behavior . These " disruptive " children were r and omly assigned to four treatment conditions lasting the kindergarten school year : no treatment , parent training only , full-day treatment classroom only , and the combination of parent training with the classroom treatment . Results showed that parent training produced no significant treatment effects , probably owing largely to poor attendance . The classroom treatment produced improvement in multiple domains : parent ratings of adaptive behavior , teacher ratings of attention , aggression , self-control , and social skills , as well as direct observations of externalizing behavior in the classroom . Neither treatment improved academic achievement skills or parent ratings of home behavior problems , nor were effects evident on any lab measures of attention , impulse control , or mother-child interactions . It is concluded that when parent training is offered at school registration to parents of disruptive children identified through a brief school registration screening , it may not be a useful approach to treating the home and community behavioral problems of such children . The kindergarten classroom intervention was far more effective in reducing the perceived behavioral problems and impaired social skills of these children . Even so , most treatment effects were specific to the school environment and did not affect achievement skills . These findings must be viewed as tentative until follow-up evaluations can be done to determine the long-term outcomes of these interventions First through fourth grade rs from 22 suburban elementary schools were screened for cross- setting disruptive behavior as eligibility criteria for participation in a longitudinal secondary prevention study aim ed at reducing the risk for serious externalizing behavioral disorders . Three hundred nine subjects participated in either a multicomponent competence enhancement intervention ( MCEI ) or an information/attention control ( IAC ) condition over a 2-year period . Following baseline measurements , initial intervention effects were assessed at the end of intervention Year 1 , at the beginning of intervention Year 2 ( fall of the next school year ) , and at the end of intervention Year 2 . Multi source assessment s were not supportive of the efficacy of the MCEI over the IAC condition . Children in both groups rated themselves as improved over time in terms of increased adaptive skills and decreased school problems and internalizing symptoms . Teacher and parent ratings of externalizing behavior did not yield evidence of positive change , but teachers noted improved problem solving and observers noted a decrease in behavioral interference in both groups over time , possibly as a result of maturation OBJECTIVE To compare the effectiveness of the Violence Prevention Curriculum for Adolescents  to the Conflict Resolution : A Curriculum for Youth Providers among middle school students . METHODS A sample ( N = 225 ) of adolescents ( males = 48 % ) representing 20 % of the student population in two middle schools were administered a pretest question naire . Of these students , 89 % were African-American , 10 % were white , and 1 % were Native-American and lived in public housing ( 40 % ) or in neighborhoods adjacent to public housing ( 60 % ) . Each school was r and omly assigned to one of the curricula . Each curriculum was administered during 10 50-min sessions held twice a week over 5 weeks . One week later , 209 students who completed the 10 sessions were tested with the same question naire . The data were analyzed with a repeated- measures analysis of variance . RESULTS Students who received either curriculum reported significant decreases in their self-reported use of violence in hypothetical conflict situations , frequency of use of violence in the previous 30 days , and frequency of physical fights in the previous 30 days . The conflict resolution curriculum was more effective in reducing the frequency of fights result ing in an injury requiring medical treatment in the previous 30 days . CONCLUSIONS Both curricula were successful in reducing three indicators of violence . However , the conflict resolution approach was more successful in reducing the frequency of more severe physical fights requiring medical treatment . The latter finding is of particular importance , because that physical fighting is the form of violence behavior in which young adolescents most often engage An attributional intervention was design ed to reduce aggressive males ' tendency to attribute hostile intentions to peers following ambiguously caused peer provocations . African-American elementary school boys ( N = 101 ) , aggressive and nonaggressive , were r and omly assigned to the attributional intervention , an attention training program , or a no-treatment control group . Data were collected on subjects ' attributions about hypothetical and laboratory simulations of peer provocation , disciplinary referrals to the school office , and teacher ratings of aggressive behavior . Aggressive subjects in the attributional intervention were less likely to presume hostile intent by peers in hypothetical and laboratory simulations of ambiguous provocation . They were also less likely to endorse hostile retaliation on judgment measures and to engage in verbally hostile behaviors in the laboratory task . Further , intervention subjects were rated as less aggressive by their teachers following the treatment . Both the benefits of attributional change and its limitations in the African-American population are discussed From a school population of normal children third through fifth grade s ) , thirty children initially identified as “ angry”were r and omly assigned to either an affective imagery training group , an attention group , or a control group . The treatment group received three sessions of affective imagery in which they focused on physiological changes and on their thoughts associated with prior emotional experiences . Teachers recorded pre- , post- , and short term follow-up aggressive behaviors for all thirty children . Cognitive perceptions and attributions were recorded at the same three occasions on the Affect Question naire . Results suggested that , as a result of affective imagery training , angry children 's perceptions and cognitions shifted from “ angry ” towards “ sad , ” and there was a concomitant decrease in observed aggressive classroom behavior Fast Track is a multisite , multicomponent preventive intervention for young children at high risk for long-term antisocial behavior . Based on a comprehensive developmental model , intervention included a universal-level classroom program plus social skills training , academic tutoring , parent training , and home visiting to improve competencies and reduce problems in a high-risk group of children selected in kindergarten . At the end of Grade 1 , there were moderate positive effects on children 's social , emotional , and academic skills ; peer interactions and social status ; and conduct problems and special-education use .  Parents reported less physical discipline and greater parenting satisfaction/ease of parenting and engaged in more appropriate/consistent discipline , warmth/positive involvement , and involvement with the school . Evidence of differential intervention effects across child gender , race , site , and cohort was minimal This paper describes a preventive intervention trial called EARLY ALLIANCE which is aim ed at reducing risk for three adverse outcomes in childhood and adolescence :  conduct problems , substance abuse , and school failure . The structure of the prevention trial is unique because two linked design s are being implemented concurrently . The primary design focuses on children at elevated risk for adverse outcomes , and compares a targeted , multi context ual preventive intervention with family , classroom , peer relational , and academic components to a universal , schoolwide preventive intervention that emphasizes peaceful conflict management and serves as a " usual care " control condition . The secondary design focuses on children at lower risk for adverse outcomes and compares a universally administered classroom program to the control condition . The paper describes the theoretical foundation for EARLY ALLIANCE , the goals of the prevention trial , the rationale for design choices , and the methods employed The Montréal Longitudinal Study of Disruptive Boys , an experimental study , was design ed to underst and boys who were considered disruptive in kindergarten . One part of the study involved assessing effects of a preventive treatment program carried out during the boys ' early years in primary school . This paper reports on the outcome of the r and omized treatment experiment 3 years after treatments ended . Disruptive boys were r and omly allocated to a treated group and two nontreated groups . Treatment consisted of parent training and training of boys for social skills , fantasy play and television viewing .  Results suggest that the treatment program had some positive effects . Some of the improvements were not evident immediately after treatment ended The purpose s of this study were to examine the type of response to different situations displayed by children with or without conduct disorders and to assess the efficacy of the social skills training program herein proposed for modifying styles of interpersonal relationship in children . The sample included 315 children , 8 to 12 years of age . Those exhibiting conduct problems were 164 boys , and those having no conduct problems were 151 boys . All participants shared a low socioeconomic and cultural status and attended schools located in poor districts of Mendoza City in Argentina . Analysis showed that the groups trained in social skills improved in social interaction by reducing disruptive behaviors , whereas the groups without social skills training showed no behavioral changes . These data were confirmed by the teachers ' assessment s. These results suggest social skills training seems an efficient therapeutic approach to the attenuation of behavior disorders of boys V and alism is a major problem facing educators and taxpayers alike . The present investigation analyzed how v and alism costs and student disruption were related to the implementation of a training and consultation package design ed to increase the reinforcing ambience of the school . A positive environment , it was posited , would displace previous events that may have set the occasion for v and alism , with cues to promote productive school performance . Eighteen elementary and junior high schools were involved over a 3-year period . Using a delayed treatment control design , treatment was delivered following either 4 or 13 months of baseline . During treatment , teams of school personnel attended training workshops in behavioral strategies for reducing v and alism and disruption by students in school . Each team also met regularly on its campus to plan and implement programs on a schoolwide basis . To demonstrate that reinforcing procedures were actually implemented and accompanied by change in student performance , these variables were periodically probed throughout the study . Project staff also provided consultation . V and alism costs decreased significantly ( p less than .05 ) more in treatment than control schools , with an average reduction of 78.5 % for all project schools . Rates of praise delivered by project teachers and other r and omly selected teachers in the school increased significantly ( p less than .05 ) , and rates of off-task behavior by students decreased significantly ( p less than .05 ) following treatment . The staff development model used in this study appeared to be both feasible and economical Thirty-two boys who were rejected by their peers in Grade s 1 - 3 were identified on the basis of negative sociometric nominations and negative social behavior . They were r and omly assigned to one of four treatment conditions : ( a ) instructions to promote positive social behavior , ( b ) prohibitions to reduce negative social behavior , ( c ) a combination of instructions and prohibitions , or ( d ) no treatment . Interventions were applied during 10 half-hour school play sessions . Behavioral observations and peer and teacher ratings were collected 
    Output:
    
School-based secondary prevention programmes to reduce aggressive behaviour appear to produce improvements in behaviour greater than would have been expected by chance .
Benefits can be achieved in both primary and secondary school age groups and in both mixed sex groups and boys-only groups .