***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 : To investigate the effect of two contrasting physical activity worksite interventions versus a reference intervention ( REF ) on various health outcomes . Methods : A 1-year r and omized controlled trial was conducted with specific resistance training ( SRT ) , all-round physical exercise ( APE ) , and REF . Results : SRT and APE compared with REF showed significant reductions in systolic blood pressure ( ∼6 mm Hg ) , body fat percentage ( ∼2.2 body fat% ) , as well as shoulder and back pain ( ∼30 % reduction in duration ) . Muscle strength ( APE and SRT ) and maximal oxygen uptake ( APE ) increased approximately 10 % . Conclusions : Worksite intervention with both SRT as well as APE is recommended , since these activities compared with REF result ed in clinical ly relevant reductions of cardiovascular and metabolic syndrome-related risk factors as well as musculoskeletal pain symptoms , in combination with minor increases in physical capacity Purpose of review This review highlights recent work evaluating the relationship between exercise , physical activity and physical and mental health . Both cross-sectional and longitudinal studies , as well as r and omized clinical trials , are included . Special attention is given to physical conditions , including obesity , cancer , cardiovascular disease and sexual dysfunction . Furthermore , studies relating physical activity to depression and other mood states are review ed . The studies include diverse ethnic population s , including men and women , as well as several age groups ( e.g. adolescents , middle-aged and older adults ) . Recent findings Results of the studies continue to support a growing literature suggesting that exercise , physical activity and physical-activity interventions have beneficial effects across several physical and mental-health outcomes . Generally , participants engaging in regular physical activity display more desirable health outcomes across a variety of physical conditions . Similarly , participants in r and omized clinical trials of physical-activity interventions show better health outcomes , including better general and health-related quality of life , better functional capacity and better mood states . Summary The studies have several implication s for clinical practice and research . Most work suggests that exercise and physical activity are associated with better quality of life and health outcomes . Therefore , assessment and promotion of exercise and physical activity may be beneficial in achieving desired benefits across several population s. Several limitations were noted , particularly in research involving r and omized clinical trials . These trials tend to involve limited sample sizes with short follow-up periods , thus limiting the clinical implication s of the benefits associated with physical activity . Abbreviations CAD : coronary artery disease ; COPD : chronic obstructive pulmonary disease ; CRP : cardiac rehabilitation program ; CVD : cardiovascular disease ; GMCB : group-mediated cognitive – behavioural ; HRQOL : health-related quality of life Objectives : To determine the effects of sporting activity on absenteeism in a working population . Methods : Data were used from a prospect i ve cohort study in a working population with a follow up period of 3 years and were collected with yearly question naires or collected from company records . Complete data on absenteeism , sporting activity , and potential confounders were collected for 1228 workers .  ANOVA was used to test differences in frequency and duration of absenteeism , correlations were computed to measure the association between number of sporting years ( divided by age ) and frequency and duration of absenteeism , and survival analysis , according to the Cox proportional hazards model , was used to test differences in relative risk at absenteeism and recovery . All analyses were adjusted for age , gender , smoking , and alcohol consumption , and were stratified for employees with sedentary and with more active jobs . Results : ANOVA showed a statistically significant higher mean duration of absenteeism among employees not practicing sports  , of approximately 20 days over a period of 4 years . The survival analysis showed an increased relative risk at absenteeism ( relative risk ( RR ) 1.09 ; confidence interval ( CI ) 1.01 to 1.18 ) and a decreased relative risk at recovery ( RR 0.90 ; CI 0.85 to 0.95 ) for employees not practicing sports . The effect of sporting activity  is larger in employees with sedentary work . No associations were found between number of sporting years and absenteeism . Conclusion : Employees practicing sports  take sick leave significantly less often than their colleagues not practicing sports , while their periods of sick leave are shorter , especially when their work is sedentary Highly stressed employees are subject to greater health risks , increased cost , and productivity losses than those with normal stress levels . To address this issue in an evidence -based manner , worksite stress management programs must be able to engage individuals as well as capture data on stress , health indices , work productivity , and health care costs . In this r and omized controlled pilot , our primary objective was to evaluate the viability and proof of concept for two mind-body workplace stress reduction programs ( one therapeutic yoga-based and the other mindfulness-based ) , in order to set the stage for larger cost-effectiveness trials . A second objective was to evaluate 2 delivery venues of the mindfulness-based intervention ( online vs. in-person ) . Intention-to-treat principles and 2 ( pre and post ) × 3 ( group ) repeated- measures analysis of covariance procedures examined group differences over time on perceived stress and secondary measures to clarify which variables to include in future studies : sleep quality , mood , pain levels , work productivity , mindfulness , blood pressure , breathing rate , and heart rate variability ( a measure of autonomic balance ) . Two hundred and thirty-nine employee volunteers were r and omized into a therapeutic yoga worksite stress reduction program , 1 of 2 mindfulness-based programs , or a control group that participated only in assessment . Compared with the control group , the mind-body interventions showed significantly greater improvements on perceived stress , sleep quality , and the heart rhythm coherence ratio of heart rate variability . The two delivery venues for the mindfulness program produced basically equivalent results . Both the mindfulness-based and therapeutic yoga programs may provide viable and effective interventions to target high stress levels , sleep quality , and autonomic balance in employees Integrating organizationally targeted wellness strategies into the routine conduct of business has shown promise in engaging captive audiences at highest risk of obesity and obesity-related health consequences . This paper presents a process evaluation of the implementation of the University of California , Los Angeles , Working Out Regularly Keeps Individuals Nurtured and Going ( WORKING ) pilot study . WORKING focuses on integrating physical activity and nutrition practice s into workplace routine during non-discretionary paid work time . The purpose of the evaluation was to assess the quality of implementation and to underst and factors that facilitated or hindered organizations ' full uptake of the intervention . Fifteen worksites were r and omly assigned to an intervention condition . Qualitative data were gathered through routine site visits and informant interviews conducted throughout each worksite 's intervention period . Worksites were classified into one of four implementation success categories based on their level of adoption and maintenance of core intervention strategies . Six key factors emerged that were related to implementation success : site layout and social climate , wellness infrastructure , number and influence of Program Champions , leadership involvement , site innovation and creativity . This pilot study has informed the conduct of WORKING II ; a cluster r and omized controlled trial aim ed at enrolling 60 - 70 worksites in Los Angeles County Background Only a few workplace initiatives among cleaners have been reported , even though they constitute a job group in great need of health promotion . The purpose of this trial was to evaluate the effect of either physical coordination training or cognitive behavioural training on musculoskeletal pain , work ability and sickness absence among cleaners . Methods A cluster-r and omised controlled trial was conducted among 294 female cleaners allocated to either physical coordination training ( PCT ) , cognitive behavioural training ( CBTr ) or a reference group ( REF ) .  Question naires about musculoskeletal pain and work ability were completed at baseline and after one year 's intervention . Sickness absence data were obtained from the managers ' records . Analyses were performed according to the intention-to-treat-principle ( ITT ) . Results No overall reduction in musculoskeletal pain , work ability or sickness absence from either PCT or CBTr compared with REF was found in conservative ITT analyses . However , explorative analyses revealed a treatment effect for musculoskeletal pain of the PCT . People with chronic neck/shoulder pain at baseline were more frequently non-chronic at follow-up after PCT compared with REF ( p = 0.05 ) . Conclusions The PCT intervention appeared effective for reducing chronic neck/shoulder pain among the female cleaners . It is recommended that future interventions among similar high-risk job groups focus on the implementation aspects of the interventions to maximise outcomes more distal from the intervention such as work ability and sickness absence . Trial registration IS RCT N : IS RCT Objective .The objective of this work was to develop a psychometrically sound question naire for measuring the on-the-job impact of chronic health problems and /or treatment ( “ work limitations ” ) . Research Design .Three pilot studies ( focus groups , cognitive interviews , and an alternate forms test ) generated c and i date items , dimensions , and response scales . Two field trials tested the psychometric performance of the question naire ( studies 1 and 2 ) . To test recall error , study 1 subjects were r and omly assigned to 2 different question naire groups , a question naire with a 4-week reporting period completed once or a 2-week version completed twice . Responses were compared with data from concurrent work limitation diaries ( the gold st and ard ) . To test construct validity , we compared question naire scores of patients with those of healthy job-matched control subjects . Study 2 was a cross-sectional mail survey testing scale reliability and construct validity . Subjects . The study subjects were employed individuals ( 18–64 years of age ) from several chronic condition groups ( study 1 , n = 48 ; study 2 , n = 121 ) and , in study 1 , 17 healthy matched control subjects . Measures . Study 1 included the assigned question naires and weekly diaries . Study 2 included the new question naire , SF-36 , and work productivity loss items . Results .In study 1 , question naire responses were consistent with diary data but were most highly correlated with the most recent week . Patients had significantly higher ( worse ) limitation scores than control subjects . In study 2 , 4 scales from a 25-item question naire achieved Cronbach alphas of ≥0.90 and correlated with health status and self-reported work productivity in the hypothesized manner ( P ≤0.05 ) . Conclusions .With 25 items , 4 dimensions ( limitations h and ling time , physical , mental-interpersonal , and output dem and s ) , and a 2-week reporting period , the Work Limitations Question naire demonstrated high reliability and validity Background Whether the association of alcohol consumption and cardiovascular disease is the product of confounding and the degree to which this concern applies to other behaviors are unclear . Methods Using the 2003 Behavioral Risk Factor Surveillance System , a population -based telephone survey of adults in the US , we compared chronic disease risk factors between 123,359 abstainers and 126,674 moderate drinkers , defined as intake of ≤ 2 drinks per day among men and ≤ 1 drink per day among women , using age- and sex- and multivariable-adjusted models . We also compared sedentary and active individuals , defined as moderate physical activity ≥ 30 minutes per day for ≥ 5 days per week , or vigorous activity for ≥ 20 minutes per day on ≥ 3 days . Results Chronic disease risk factors and features of unhealthy lifestyle were generally more prevalent among abstainers than drinkers in age- and sex-adjusted analyses , but these differences were generally attenuated or eliminated by additional adjustment for race and education . For low fruit and vegetable intake , divorced marital status , and absence of a personal physician , adjustment for race and education reversed initially positive age- and sex-adjusted associations with abstention . Comparison of sedentary and active individuals produced similar findings , with generally lower levels of risk factors among more physical active individuals . Conclusion The differences between abstainers and drinkers are attenuated after adjustment for limited sociodemographic features , and sedentary and active individuals share a similar pattern . Although observational studies of both factors may be susceptible to uncontrolled confounding , our results provide no evidence that moderate drinking is unique in this regard . Ultimately , r and omized trials of all such lifestyle factors will be needed to answer these questions definitively AIM This paper is the report of a pilot study to assess if an Integrated Health Programme would reduce sick leave and subjective health complaints , and increase coping in a population of nursing personnel . BACKGROUND . The work group in Norway with most sick leave is healthcare workers . More than 50 % of the sick leave is because of subjective health complaints . Work place physical exercise interventions have a documented positive effect on sick leave . METHOD After baseline screening , employees who had agreed to participate ( n=40 ) were r and omized to an intervention or control group . The intervention group participated in an Integrated Health Programme twice weekly during working hours . The programme consisted of physical exercise , stress management training , health information and an examination of the participants ' workplace . The control group was offered the same intervention after the project was finished . This study was carried out from 2001 to 2002 . FINDINGS There were no statistically significant effects on sick leave or health-related quality of life . The intervention group reported fewer neck complaints compared to the control group , but otherwise there were no effects on subjective health complaints . However , the subjective effects were large and highly statistically significant , the intervention group reporting improvement in health , physical fitness , muscle pain , stress management , maintenance of health and work situation . CONCLUSION The Integrated Health Programme was not effective in reducing sick leave and subjective health complaints , but may be of use to employers wanting to increase employee job satisfaction and well-being BACKGROUND It is a common belief that physical exercise at the workplace decreases subjective health complaints and reduces sickness absence , but this is not supported by previous r and omized studies . AIMS To evaluate the effectiveness of physical exercise at the workplace . METHODS One hundred and 
    Output:
    
There is consistent evidence that onsite workplace HEPA programmes do not reduce levels of sick leave .
There is inconsistent evidence that onsite workplace HEPA programmes improve self-reported worker productivity .