human
***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: A home visit intervention program for adolescents throughout their pregnancy and during the early stages of motherhood was evaluated . The participants ( N = 90 ) were part of a larger group of adolescents treated in two health centers in a poor neighborhood in Santiago , Chile . The program was carried out by volunteer community health monitors and evaluated through an experimental , r and omized , controlled clinical trial . Cost-effectiveness was examined in comparison with st and ard health care . Results show higher scores for the intervention group on the mothers ’ mental health and nutritional state , as well as on the children ’s levels of linguistic development Combined psychosocial and nutrition interventions improve the development of infants . However , there is a paucity of studies examining the effectiveness of such interventions in humanitarian setting s. This article examines the impact of combining a group-based psychosocial intervention with an existing emergency feeding program for internally displaced mothers in Northern Ug and a. The intervention consisted of mother and baby group sessions and home visits for mothers attending 3 emergency feeding centers . Psychosocial outcomes were compared with a contrast group of mothers who received nutritional support alone . The outcomes investigated were infant stimulation and maternal mood . After controlling for the effects of interview site and baseline scores , mothers in the intervention group ( n = 70 ) showed greater involvement with their babies , more availability of play material s , and less sadness and worry at follow-up in comparison to the contrast group ( n = 77 ) . The intervention was acceptable to the mothers and easily taught . A proportion of the mothers chose to continue the intervention spontaneously with other mothers in their neighbourhoods . Further research needs to be done to vali date these preliminary findings and explore the longer term impact on child growth and intellectual development as well as maternal mood BACKGROUND WHO estimates that about 170,000 deaths by suicide occur in India every year , but few epidemiological studies of suicide have been done in the country . We aim ed to quantify suicide mortality in India in 2010 . METHODS The Registrar General of India implemented a nationally representative mortality survey to determine the cause of deaths occurring between 2001 and 2003 in 1·1 million homes in 6671 small areas chosen r and omly from all parts of India . As part of this survey , fieldworkers obtained information about cause of death and risk factors for suicide from close associates or relatives of the deceased individual . Two of 140 trained physicians were r and omly allocated ( stratified only by their ability to read the local language in which each survey was done ) to independently and anonymously assign a cause to each death on the basis of electronic field reports . We then applied the age-specific and sex-specific proportion of suicide deaths in this survey to the 2010 UN estimates of absolute numbers of deaths in India to estimate the number of suicide deaths in India in 2010 . FINDINGS About 3 % of the surveyed deaths ( 2684 of 95,335 ) in individuals aged 15 years or older were due to suicide , corresponding to about 187,000 suicide deaths in India in 2010 at these ages ( 115,000 men and 72,000 women ; age-st and ardised rates per 100,000 people aged 15 years or older of 26·3 for men and 17·5 for women ) . For suicide deaths at ages 15 years or older , 40 % of suicide deaths in men ( 45,100 of 114,800 ) and 56 % of suicide deaths in women ( 40,500 of 72,100 ) occurred at ages 15 - 29 years . A 15-year-old individual in India had a cumulative risk of about 1·3 % of dying before the age of 80 years by suicide ; men had a higher risk ( 1·7 % ) than did women ( 1·0 % ) , with especially high risks in south India ( 3·5 % in men and 1·8 % in women ) . About half of suicide deaths were due to poisoning ( mainly ingestions of pesticides ) . INTERPRETATION Suicide death rates in India are among the highest in the world . A large proportion of adult suicide deaths occur between the ages of 15 years and 29 years , especially in women . Public health interventions such as restrictions in access to pesticides might prevent many suicide deaths in India . FUNDING US National Institutes of Health BACKGROUND The risk for emotional and behavioral problems is known to be high among children of depressed mothers , but little is known about the impact of prenatal and postnatal depression on the physical health of infants . OBJECTIVE To determine whether maternal depression is a risk factor for malnutrition and illness in infants living in a low-income country . DESIGN Prospect i ve cohort study . SETTING Rural community in Rawalpindi , Pakistan . PARTICIPANTS Six hundred thirty-two physically healthy women were assessed in their third trimester of pregnancy to obtain at birth a cohort of 160 infants of depressed mothers and 160 infants of psychologically well mothers . MAIN OUTCOME MEASURES All infants were weighed and measured at birth and at 2 , 6 , and 12 months of age , and they were monitored for episodes of diarrhea and acute respiratory infections . The mothers ' mental states were reassessed at 2 , 6 , and 12 months . Data were collected on potential confounders of infant outcomes , such as birth weight and socioeconomic status . RESULTS Infants of prenatally depressed mothers showed significantly more growth retardation than controls at all time points . The relative risks for being underweight ( weight-for-age z score of less than -2 ) were 4.0 ( 95 % confidence interval [ CI ] , 2.1 to 7.7 ) at 6 months of age and 2.6 ( 95 % CI , 1.7 to 4.1 ) at 12 months of age , and the relative risks for stunting ( length-for-age z score of less than -2 ) were 4.4 ( 95 % CI , 1.7 to 11.4 ) at 6 months of age and 2.5 ( 95 % CI , 1.6 to 4.0 ) at 12 months of age . The relative risk for 5 or more diarrheal episodes per year was 2.4 ( 95 % CI , 1.7 to 3.3 ) . Chronic depression carried a greater risk for poor outcome than episodic depression . The associations remained significant after adjustment for confounders by multivariate analyses . CONCLUSIONS Maternal depression in the prenatal and postnatal periods predicts poorer growth and higher risk of diarrhea in a community sample of infants . As depression can be identified relatively easily , it could be an important marker for a high-risk infant group . Early treatment of prenatal and postnatal depression could benefit not only the mother 's mental health but also the infant 's physical health and development Objective To assess the efficacy of an intervention design ed to improve the mother-infant relationship and security of infant attachment in a South African peri-urban settlement with marked adverse socioeconomic circumstances . Design R and omised controlled trial . Setting Khayelitsha , a peri-urban settlement in South Africa . Participants 449 pregnant women . Interventions The intervention was delivered from late pregnancy and for six months postpartum . Women were visited in their homes by previously untrained lay community workers who provided support and guidance in parenting . The purpose of the intervention was to promote sensitive and responsive parenting and secure infant attachment to the mother . Women in the control group received no therapeutic input from the research team . Main outcome measures Primary outcomes : quality of mother-infant interactions at six and 12 months postpartum ; infant attachment security at 18 months . Secondary outcome : maternal depression at six and 12 months . Results The intervention was associated with significant benefit to the mother-infant relationship . At both six and 12 months , compared with control mothers , mothers in the intervention group were significantly more sensitive ( 6 months : mean difference=0.77 ( SD 0.37 ) , t=2.10 , P<0.05 , d=0.24 ; 12 months : mean difference=0.42 ( 0.18 ) , t=−2.04 , P<0.05 , d=0.26 ) and less intrusive ( 6 months : mean difference=0.68 ( 0.36 ) , t=2.28 , P<0.05 , d=0.26 ; 12 months : mean difference=−1.76 ( 0.86 ) , t=2.28 , P<0.05 , d=0.24 ) in their interactions with their infants . The intervention was also associated with a higher rate of secure infant attachments at 18 months ( 116/156 ( 74 % ) v 102/162 ( 63 % ) ; Wald=4.74 , odds ratio=1.70 , P<0.05 ) . Although the prevalence of maternal depressive disorder was not significantly reduced , the intervention had a benefit in terms of maternal depressed mood at six months ( z=2.05 , P=0.04 ) on the Edinburgh postnatal depression scale ) . Conclusions The intervention , delivered by local lay women , had a significant positive impact on the quality of the mother-infant relationship and on security of infant attachment , factors known to predict favourable child development . If these effects persist , and if they are replicated , this intervention holds considerable promise for use in the developing world . Trial registration Current Controlled Trials IS RCT N25664149 BACKGROUND Community mobilisation through participatory women 's groups might improve birth outcomes in poor rural communities . We therefore assessed this approach in a largely tribal and rural population in three districts in eastern India . METHODS From 36 clusters in Jharkh and and Orissa , with an estimated population of 228 186 , we assigned 18 clusters to intervention or control using stratified r and omisation . Women were eligible to participate if they were aged 15 - 49 years , residing in the project area , and had given birth during the study . In intervention clusters , a facilitator convened 13 groups every month to support participatory action and learning for women , and facilitated the development and implementation of strategies to address maternal and newborn health problems . The primary outcomes were reductions in neonatal mortality rate ( NMR ) and maternal depression scores . Analysis was by intention to treat . This trial is registered as an International St and ard R and omised Controlled Trial , number IS RCT N21817853 . FINDINGS After baseline surveillance of 4692 births , we monitored outcomes for 19 030 births during 3 years ( 2005 - 08 ) . NMRs per 1000 were 55.6 , 37.1 , and 36.3 during the first , second , and third years , respectively , in intervention clusters , and 53.4 , 59.6 , and 64.3 , respectively , in control clusters . NMR was 32 % lower in intervention clusters adjusted for clustering , stratification , and baseline differences ( odds ratio 0.68 , 95 % CI 0.59 - 0.78 ) during the 3 years , and 45 % lower in years 2 and 3 ( 0.55 , 0.46 - 0.66 ) . Although we did not note a significant effect on maternal depression overall , reduction in moderate depression was 57 % in year 3 ( 0.43 , 0.23 - 0.80 ) . INTERPRETATION This intervention could be used with or as a potential alternative to health-worker-led interventions , and presents new opportunities for policy makers to improve maternal and newborn health outcomes in poor population s. FUNDING Health Foundation , UK Department for International Development , Wellcome Trust , and the Big Lottery Fund ( UK ) BACKGROUND A high rate of maternal depression and associated disturbance in the mother-infant relationship has been found in an indigent peri-urban South African community , Khayelitsha . The question arises whether a community-based intervention could be beneficial . AIMS To train community workers to deliver an intervention to mothers and infants in Khayelitsha , and to compare mothers and infants receiving this intervention with a sample receiving no such intervention . METHOD Four Khayelitsha women were trained in a mother-infant intervention  , which they delivered to 32 women recruited in late pregnancy . At 6 months post-partum , maternal mood , the mother-infant relationship and infant growth were assessed . The findings were compared with a matched group of 32 mothers and infants . RESULTS There was no reliable impact of the intervention on maternal mood . However , compared with the comparison sample , the quality of mother-infant engagement was significantly more positive for those who had received the intervention . CONCLUSIONS The pilot study produced preliminary evidence of a benefit of a community-based mother-infant intervention delivered by trained , but otherwise unqualified , community workers , sufficient to warrant a formal controlled evaluation of this treatment OBJECTIVE The aim of this study was to compare the effect of nursing intervention to the effect of problem solving training on the level of  postpartum depressive symptom .  METHODS We utilized a pretest-posttest mutual controlled semi experimental model for this study . The study consisted of 62 women ( 30 in care group and 32 in training group ) , all of who were at risk for postpartum depression , but without major depressive symptoms . These women were not undergoing pharmacologic or psychotherapeutic treatment , were all literate and consented to join the study in Erzurum , Turkey . Participants ( N=62 ) , recruited over a 9 month , were r and omly assigned to one of two groups . Women in care group ( average age=21 , 33.3 % primaparus ) 
    Output:
    
agent
***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: A home visit intervention program for adolescents throughout their pregnancy and during the early stages of motherhood was evaluated . The participants ( N = 90 ) were part of a larger group of adolescents treated in two health centers in a poor neighborhood in Santiago , Chile . The program was carried out by volunteer community health monitors and evaluated through an experimental , r and omized , controlled clinical trial . Cost-effectiveness was examined in comparison with st and ard health care . Results show higher scores for the intervention group on the mothers ’ mental health and nutritional state , as well as on the children ’s levels of linguistic development Combined psychosocial and nutrition interventions improve the development of infants . However , there is a paucity of studies examining the effectiveness of such interventions in humanitarian setting s. This article examines the impact of combining a group-based psychosocial intervention with an existing emergency feeding program for internally displaced mothers in Northern Ug and a. The intervention consisted of mother and baby group sessions and home visits for mothers attending 3 emergency feeding centers . Psychosocial outcomes were compared with a contrast group of mothers who received nutritional support alone . The outcomes investigated were infant stimulation and maternal mood . After controlling for the effects of interview site and baseline scores , mothers in the intervention group ( n = 70 ) showed greater involvement with their babies , more availability of play material s , and less sadness and worry at follow-up in comparison to the contrast group ( n = 77 ) . The intervention was acceptable to the mothers and easily taught . A proportion of the mothers chose to continue the intervention spontaneously with other mothers in their neighbourhoods . Further research needs to be done to vali date these preliminary findings and explore the longer term impact on child growth and intellectual development as well as maternal mood BACKGROUND WHO estimates that about 170,000 deaths by suicide occur in India every year , but few epidemiological studies of suicide have been done in the country . We aim ed to quantify suicide mortality in India in 2010 . METHODS The Registrar General of India implemented a nationally representative mortality survey to determine the cause of deaths occurring between 2001 and 2003 in 1·1 million homes in 6671 small areas chosen r and omly from all parts of India . As part of this survey , fieldworkers obtained information about cause of death and risk factors for suicide from close associates or relatives of the deceased individual . Two of 140 trained physicians were r and omly allocated ( stratified only by their ability to read the local language in which each survey was done ) to independently and anonymously assign a cause to each death on the basis of electronic field reports . We then applied the age-specific and sex-specific proportion of suicide deaths in this survey to the 2010 UN estimates of absolute numbers of deaths in India to estimate the number of suicide deaths in India in 2010 . FINDINGS About 3 % of the surveyed deaths ( 2684 of 95,335 ) in individuals aged 15 years or older were due to suicide , corresponding to about 187,000 suicide deaths in India in 2010 at these ages ( 115,000 men and 72,000 women ; age-st and ardised rates per 100,000 people aged 15 years or older of 26·3 for men and 17·5 for women ) . For suicide deaths at ages 15 years or older , 40 % of suicide deaths in men ( 45,100 of 114,800 ) and 56 % of suicide deaths in women ( 40,500 of 72,100 ) occurred at ages 15 - 29 years . A 15-year-old individual in India had a cumulative risk of about 1·3 % of dying before the age of 80 years by suicide ; men had a higher risk ( 1·7 % ) than did women ( 1·0 % ) , with especially high risks in south India ( 3·5 % in men and 1·8 % in women ) . About half of suicide deaths were due to poisoning ( mainly ingestions of pesticides ) . INTERPRETATION Suicide death rates in India are among the highest in the world . A large proportion of adult suicide deaths occur between the ages of 15 years and 29 years , especially in women . Public health interventions such as restrictions in access to pesticides might prevent many suicide deaths in India . FUNDING US National Institutes of Health BACKGROUND The risk for emotional and behavioral problems is known to be high among children of depressed mothers , but little is known about the impact of prenatal and postnatal depression on the physical health of infants . OBJECTIVE To determine whether maternal depression is a risk factor for malnutrition and illness in infants living in a low-income country . DESIGN Prospect i ve cohort study . SETTING Rural community in Rawalpindi , Pakistan . PARTICIPANTS Six hundred thirty-two physically healthy women were assessed in their third trimester of pregnancy to obtain at birth a cohort of 160 infants of depressed mothers and 160 infants of psychologically well mothers . MAIN OUTCOME MEASURES All infants were weighed and measured at birth and at 2 , 6 , and 12 months of age , and they were monitored for episodes of diarrhea and acute respiratory infections . The mothers ' mental states were reassessed at 2 , 6 , and 12 months . Data were collected on potential confounders of infant outcomes , such as birth weight and socioeconomic status . RESULTS Infants of prenatally depressed mothers showed significantly more growth retardation than controls at all time points . The relative risks for being underweight ( weight-for-age z score of less than -2 ) were 4.0 ( 95 % confidence interval [ CI ] , 2.1 to 7.7 ) at 6 months of age and 2.6 ( 95 % CI , 1.7 to 4.1 ) at 12 months of age , and the relative risks for stunting ( length-for-age z score of less than -2 ) were 4.4 ( 95 % CI , 1.7 to 11.4 ) at 6 months of age and 2.5 ( 95 % CI , 1.6 to 4.0 ) at 12 months of age . The relative risk for 5 or more diarrheal episodes per year was 2.4 ( 95 % CI , 1.7 to 3.3 ) . Chronic depression carried a greater risk for poor outcome than episodic depression . The associations remained significant after adjustment for confounders by multivariate analyses . CONCLUSIONS Maternal depression in the prenatal and postnatal periods predicts poorer growth and higher risk of diarrhea in a community sample of infants . As depression can be identified relatively easily , it could be an important marker for a high-risk infant group . Early treatment of prenatal and postnatal depression could benefit not only the mother 's mental health but also the infant 's physical health and development Objective To assess the efficacy of an intervention design ed to improve the mother-infant relationship and security of infant attachment in a South African peri-urban settlement with marked adverse socioeconomic circumstances . Design R and omised controlled trial . Setting Khayelitsha , a peri-urban settlement in South Africa . Participants 449 pregnant women . Interventions The intervention was delivered from late pregnancy and for six months postpartum . Women were visited in their homes by previously untrained lay community workers who provided support and guidance in parenting . The purpose of the intervention was to promote sensitive and responsive parenting and secure infant attachment to the mother . Women in the control group received no therapeutic input from the research team . Main outcome measures Primary outcomes : quality of mother-infant interactions at six and 12 months postpartum ; infant attachment security at 18 months . Secondary outcome : maternal depression at six and 12 months . Results The intervention was associated with significant benefit to the mother-infant relationship . At both six and 12 months , compared with control mothers , mothers in the intervention group were significantly more sensitive ( 6 months : mean difference=0.77 ( SD 0.37 ) , t=2.10 , P<0.05 , d=0.24 ; 12 months : mean difference=0.42 ( 0.18 ) , t=−2.04 , P<0.05 , d=0.26 ) and less intrusive ( 6 months : mean difference=0.68 ( 0.36 ) , t=2.28 , P<0.05 , d=0.26 ; 12 months : mean difference=−1.76 ( 0.86 ) , t=2.28 , P<0.05 , d=0.24 ) in their interactions with their infants . The intervention was also associated with a higher rate of secure infant attachments at 18 months ( 116/156 ( 74 % ) v 102/162 ( 63 % ) ; Wald=4.74 , odds ratio=1.70 , P<0.05 ) . Although the prevalence of maternal depressive disorder was not significantly reduced , the intervention had a benefit in terms of maternal depressed mood at six months ( z=2.05 , P=0.04 ) on the Edinburgh postnatal depression scale ) . Conclusions The intervention , delivered by local lay women , had a significant positive impact on the quality of the mother-infant relationship and on security of infant attachment , factors known to predict favourable child development . If these effects persist , and if they are replicated , this intervention holds considerable promise for use in the developing world . Trial registration Current Controlled Trials IS RCT N25664149 BACKGROUND Community mobilisation through participatory women 's groups might improve birth outcomes in poor rural communities . We therefore assessed this approach in a largely tribal and rural population in three districts in eastern India . METHODS From 36 clusters in Jharkh and and Orissa , with an estimated population of 228 186 , we assigned 18 clusters to intervention or control using stratified r and omisation . Women were eligible to participate if they were aged 15 - 49 years , residing in the project area , and had given birth during the study . In intervention clusters , a facilitator convened 13 groups every month to support participatory action and learning for women , and facilitated the development and implementation of strategies to address maternal and newborn health problems . The primary outcomes were reductions in neonatal mortality rate ( NMR ) and maternal depression scores . Analysis was by intention to treat . This trial is registered as an International St and ard R and omised Controlled Trial , number IS RCT N21817853 . FINDINGS After baseline surveillance of 4692 births , we monitored outcomes for 19 030 births during 3 years ( 2005 - 08 ) . NMRs per 1000 were 55.6 , 37.1 , and 36.3 during the first , second , and third years , respectively , in intervention clusters , and 53.4 , 59.6 , and 64.3 , respectively , in control clusters . NMR was 32 % lower in intervention clusters adjusted for clustering , stratification , and baseline differences ( odds ratio 0.68 , 95 % CI 0.59 - 0.78 ) during the 3 years , and 45 % lower in years 2 and 3 ( 0.55 , 0.46 - 0.66 ) . Although we did not note a significant effect on maternal depression overall , reduction in moderate depression was 57 % in year 3 ( 0.43 , 0.23 - 0.80 ) . INTERPRETATION This intervention could be used with or as a potential alternative to health-worker-led interventions , and presents new opportunities for policy makers to improve maternal and newborn health outcomes in poor population s. FUNDING Health Foundation , UK Department for International Development , Wellcome Trust , and the Big Lottery Fund ( UK ) BACKGROUND A high rate of maternal depression and associated disturbance in the mother-infant relationship has been found in an indigent peri-urban South African community , Khayelitsha . The question arises whether a community-based intervention could be beneficial . AIMS To train community workers to deliver an intervention to mothers and infants in Khayelitsha , and to compare mothers and infants receiving this intervention with a sample receiving no such intervention . METHOD Four Khayelitsha women were trained in a mother-infant intervention  , which they delivered to 32 women recruited in late pregnancy . At 6 months post-partum , maternal mood , the mother-infant relationship and infant growth were assessed . The findings were compared with a matched group of 32 mothers and infants . RESULTS There was no reliable impact of the intervention on maternal mood . However , compared with the comparison sample , the quality of mother-infant engagement was significantly more positive for those who had received the intervention . CONCLUSIONS The pilot study produced preliminary evidence of a benefit of a community-based mother-infant intervention delivered by trained , but otherwise unqualified , community workers , sufficient to warrant a formal controlled evaluation of this treatment OBJECTIVE The aim of this study was to compare the effect of nursing intervention to the effect of problem solving training on the level of  postpartum depressive symptom .  METHODS We utilized a pretest-posttest mutual controlled semi experimental model for this study . The study consisted of 62 women ( 30 in care group and 32 in training group ) , all of who were at risk for postpartum depression , but without major depressive symptoms . These women were not undergoing pharmacologic or psychotherapeutic treatment , were all literate and consented to join the study in Erzurum , Turkey . Participants ( N=62 ) , recruited over a 9 month , were r and omly assigned to one of two groups . Women in care group ( average age=21 , 33.3 % primaparus ) 
    Output:
    