***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: OBJECTIVES The purpose of this r and omized controlled trial was to test the efficacy and effectiveness of process consultation consisting of a series of nurse manager-consultant problem-solving meetings for leadership development that would lead to their staff 's improved morale , quality of care , and reduced absenteeism . METHODS Thirteen consenting clinical inpatient units were stratified for four variables known to affect outcome and were then r and omly assigned to treatment and control conditions . The nurse managers from the seven experimental units were paired with  outside nurse consultants from the McMaster University School of Nursing ( Hamilton , Ontario , Canada ) in a cooperative form of retraining in problem-solving through process consultation .  Morale was determined through measures of perceptions of the work environment , an attitude scale concerning work ( alienation ) , a personality measure ( hardiness ) , and one of each scale for work satisfaction and for sources of satisfaction and dissatisfaction . Demographic data and information regarding family life responsibilities were collected as well . Assessment of quality of care was determined by the frequency and type of incident reports and by patients ' perception of their satisfaction . A ratio of absence hours to total paid hours of work was used to compare experimental and control units ' absenteeism rates . RESULTS Experimental subjects reported a statistically significant improvement in the characteristics of their work setting and in the quality of working relationships . The consultation process facilitated a perceived change in the organizational context of the experimental hospital units with less central ization of authority and more clarity about expectation . These organizational changes were accompanied by improved working relationships and less alienation from work . There was no statistically significant difference in absenteeism . However , a sub analysis of the units by " dose " of the intervention identified those who benefited from the effects of the consultation . Subjects whose nurse managers participated more actively in the consultation process accounted for the changes in working relationships and perceived organizational changes . The " low-dose " experimental subjects were more like the control subjects , with the exception of absenteeism , for which they had higher rates . CONCLUSIONS The findings of this study suggest that process consultation can alter the staff 's perceptions of the characteristics of the work setting , can reverse negative attitudes ( alienation ) , and can create a more positive and supportive working environment ( improved working relationship ) . However , the results suggest the need to target this type of intervention to managers who have the personal re sources to engage in self-evaluation and personal development and thus to participate in the consultative process Purpose . This study analyzed correlates of workers ' perceptions of the extent to which their work environment is healthy and how these perceptions influence job satisfaction , employee commitment , workplace morale , absenteeism , and intent to quit . Design . One-time cross-sectional telephone survey . Setting . Canadian employees in 2000 . Subjects . A r and omly chosen , nationally representative sample of 2500 employed respondents , using a household sampling frame . The response rate was 39.2 % . Self-employed individuals were excluded , leaving a sub sample of 2112 respondents . Measures . The dependent variable was the response to the item ,  “ The work environment is healthy ” ( 5-point strongly agree – strongly disagree Likert scale ) . Independent variables used in bivariate and ordinary least-squares regression analyses included sociodemographic characteristics , employment status , organizational characteristics , and scales that measured job dem and s , intrinsic rewards , extrinsic rewards , communication/social support , employee influence , and job re sources . Perceptions of a healthy work environment were related to job satisfaction , commitment , morale ( measured on a 5-point scale ) , number of self-reported absenteeism days in the past 12 months , and whether or not the respondent had looked for a job with another employer in the past 12 months . Results . The strongest correlate of a healthy work environment was a scale of good communication and social support ( beta = .27 ) . The next strongest was a job dem and s scale ( beta = –.15 . ) Employees in self-rated healthier work environments had significantly ( p < 0.01 ) higher job satisfaction , commitment and morale , and lower absenteeism and intent to quit . Conclusions . The study supports a comprehensive model of workplace health that targets working conditions , work relationships , and workplace organization for health promotion interventions BACKGROUND High rates of work-related injuries are seen among health care workers involved in lifting and transferring patients . We studied the effects of a participatory worker-management ergonomics team among hospital orderlies . METHODS This prospect i ve intervention trial examined work injuries and other outcomes before and after the intervention , with other hospital employees used as a concurrent control . All orderlies in a 1,200-bed urban hospital were studied using passively collected data ( mean employment during study period 100 - 110 orderlies ) ; 67 orderlies ( preintervention ) and 88 orderlies ( postintervention ) also completed a question naire . The intervention was the formation of a participatory ergonomics team with three orderlies , one supervisor , and technical advisors . This team design ed and implemented changes in training and work practice s. RESULTS The 2-year postintervention period was marked by decreased risks of work injury ( RR = 0.50 , 95 % CI 0.35 - 0.72 ) , lost time injury ( RR = 0.26 , 95 % CI 0.14 - 0.48 ) , and injury with three or more days of time loss ( RR = 0.19 , 95 % CI 0.07 - 0.53 ) . Total lost days declined from 136.2 to 23.0 annually per 100 full-time worker equivalents ( FTE ) . Annual workers ' compensation costs declined from $ 237/FTE to $ 139/FTE . The proportion of workers with musculoskeletal symptoms declined and there were statistically significant improvements in job satisfaction , perceived psychosocial stressors , and social support among the orderlies . CONCLUSION Substantial improvements in health and safety were seen following implementation of a participatory ergonomics program The aim of this Intervention was to evaluate the effect of training on patient-h and ling skills and prospect ively to assess the effect of skill on subsequent back pain and back injuries  in nursing . Of a total of 255 nurses , 199 were assessed for their skill in patient-h and ling .  One-half (  control  group ) received traditional training in patient-h and ling , and the other half ( trained group ) received a curriculum of instruction totaling 40 hours . The skills of both groups were assessed on graduation . The control group was rated as less competent in patient-h and ling .  Nurses in both groups were question ed about the prevalence of back pain and incidence of back injuries in the first year after graduation . In multiple regression analysis , the major risk Indicators for back injuries were poor patient-h and ling skill , low numbers of repetitions in the sit-up test , and high work-load scores . High score on the hysteria scale of Middlesex Hospital Question naire was a risk Indicator for all kinds of back pain . Though back pain was Independent of patient-h and ling skill , those rated as “ bad ” or “ poor ” had more back injuries ( 24 % ) than those who had been rated as “ good ” or “ excellent ” ( 2 % ) ( P < 0.001 ) , but the difference between the trained and control groups was not statistically significant . It was concluded that back Injuries may be prevented by the teaching of patient-h and ling skills OBJECTIVE The effects and constancy of a worksite physical exercise intervention were examined in relation to the physical fitness , perceived health status , and work ability of female service workers during periods of 1 and 5 years . METHODS The subjects comprised female home care workers divided into an intervention group ( n = 50 , mean age 41.8 ( SD 10.4 ) years ) and a control group ( n = 37 , mean age 43.3 ( SD 8.8 ) years ) . The intervention group participated in 9 months of supervised exercise intervention twice a week during the workday . Functional capacity , perceived health , and work ability were assessed at the beginning of the study and after a 1- and a 5-year period of follow-up . RESULTS In the 1-year follow-up measurements , body fat had decreased ( 4 % ) and dynamic muscle performance and maximal oxygen consumption in relation to body mass ( 30 - 38 and 7 % , respectively ) had increased in the intervention group . The differences in outcome variables between the intervention and the control groups were significant ( from P = 0.014 to P < 0.001 ) . These positive effects of worksite exercise were observed despite the age of the subjects , and the changes were consistent during a 5-year period . In the control group the decline of the work ability index ( L smean ) was about three times faster than in the intervention group during the 5-year period . CONCLUSIONS Physical exercise executed in work units can be used to improve the physical capacity of female home care aides and prevent the early decline of their work ability . In jobs that are physically dem and ing , such as home care work , early prevention must start before the age-related deterioration of health and physical capacity CONTEXT Low back pain is a frequent and costly health problem . Prevention of low back pain is important both for the individual patient and from an economic perspective . OBJECTIVE To assess the efficacy of lumbar supports and education in the prevention of low back pain in industry . DESIGN A r and omized controlled trial with a factorial design . SETTING The cargo department of an airline company in the Netherl and s. PARTICIPANTS A total of 312 workers were r and omized , of whom 282 were available for the 6-month follow-up . INTERVENTIONS Subjects were r and omly assigned to 4 groups : ( 1 ) education ( lifting instructions ) and lumbar support , ( 2 ) education , ( 3 ) lumbar support , and ( 4 ) no intervention . Education consisted of 3 group sessions on lifting techniques with a total duration of 5 hours . Lumbar supports were recommended to be used during working hours for 6 months . MAIN OUTCOME MEASURES Low back pain incidence and sick leave because of back pain during the 6-month intervention period . RESULTS Compliance with wearing the lumbar support at least half the time was 43 % . In the 282 subjects for whom data were available , no statistically significant differences in back pain incidence ( 48 [ 36 % ] of 134 with lumbar support vs 51 [ 34 % ] of 148 without , P=.81 ) or in sick leave because of low back pain ( mean , 0.4 days per month with lumbar support vs 0.4 days without , P=.52 ) were found among the intervention groups . In a subgroup of subjects with low back pain at baseline , lumbar supports reduced the number of days with low back pain per month ( median , 1.2 vs 6.5 days per month ; P=.03 ) . CONCLUSIONS Overall , lumbar supports or education did not lead to a reduction in low back pain incidence or sick leave . The results of the subgroup analysis need to be confirmed by future research . Based on our results , the use of education or lumbar supports can not be recommended in the prevention of low back pain in industry Aims : To investigate the effectiveness of a worksite health promotion programme by individual counselling on sick leave . Methods : Three municipal services of Enschede , the Netherl and s , participated in this trial . A total of 299 civil servants were measured at baseline and were r and omised by cluster into the intervention ( n = 131 ) or the control group ( n = 168 ) . During nine months , subjects in the intervention group received a total of seven consultations , particularly aim ed at increasing their physical activity level and improving their dietary habits . Both the intervention and the control subjects received written information as to several lifestyle factors . Sick leave data regarding the nine month intervention period ( from May until January ) were collected from each municipal service ’s personnel department . In addition , sick leave data concerning the nine month period pre- and post-intervention were collected . Sick leave data were analysed using multilevel analysis . Results : For both groups , the mean sick leave rate during the intervention increased compared to before the intervention . After the intervention period , the control group increased even more ( from 22.9 to 27.6 days ) , whereas the intervention group slightly decreased ( from 21.5 to 20.5 days ) . Median values of sick leave rate decreased for both groups . No statistically significant intervention effect was found . In both groups , the mean sick leave frequency slightly decreased over time ( intervention effects were not significant ) . Conclusions : Results showed no significant effect of individual counselling on sick leave . Continued research investigating the effectiveness of this individual counselling programme on several health related outcomes is useful to clarify the trend observed in sick leave OBJECTIVES This multicentered r and omized controlled trial evaluated the effect of worksite exercise intervention on perceived work ability and sick leaves . METHODS Women ( N = 260 , mean age 40 years ) engaged in physically dem and ing laundry work were individually r and omized into an intervention ( N = 133 ) or control ( N = 127 ) group . Perceived work ability was assessed with question naires at 3 , 8 , 12 , and 15 months . Sick leave information was obtained from the personnel administration . Follow-up attendance was 100 % at 3 months but declined gradually to 90 % by 15 months . Both the intervention and control subjects received a 30-minute feedback on their physical capacity from a physiotherapist and individual exercise prescription and counseling . The intervention subjects also participated in worksite exercise training guided by a physiotherapist . Sixty-minute sessions ( N = 26 ) were held once a week for 8 months . About 50 % of the intervention group participated in at least two-thirds of the sessions . RESULTS According to a dichotomized work ability index , at 12 months , workers with " good " or " excellent " work ability increased more in the intervention group than in the control group ( 11.0 % , 95 % CI 0.2 - 21.9 ) , as did the health-related prognosis of work ability at 8 months ( 8.1 % , 95 % CI  
    Output:
    
Exercise seems to increase overall well-being ( RR , 1.25 ; range , 1.05 to 1.47 ) and work ability ( RR , 1.38 ; range , 1.15 to 1.66 ) , but education and psychological methods do not seem to affect well-being or sickness absences .
Work health promotion is valuable on employees ' well-being and work ability and productive in terms of less sickness absences .
Activities involving exercise , lifestyle , and ergonomics are potentially effective .
On the other h and , education and psychological means applied alone do not seem effective .