***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: AIM The purpose of this study was to examine disordered eating behaviours among nurses in the state of Ohio . BACKGROUND Individuals involved in disordered eating tend to report more frequent and higher levels of perceived stress than their counterparts . As nurses regularly perform stressful roles and responsibilities within a high-stress environment , this group may be at elevated risk of disordered eating . METHOD A 65-item survey was mailed to a r and om sample of 1000 nurses in the state of Ohio . RESULTS A total of 435 nurses ( 47 % ) returned completed surveys . Most ( 93 % ) were registered nurses ( RNs ) and 87 % were over 31 years old . Results indicated that disordered eating differed significantly based on perceived job stress and perceived body satisfaction . Nurses with high levels of perceived job stress and low levels of body satisfaction had higher disordered eating involvement . CONCLUSIONS Nurses reporting high levels of job stress are at increased risk of disordered eating behaviours . Recommendations for future research are offered . IMPLICATION S FOR NURSING MANAGEMENT Employee wellness programmes should be developed that educate and support nurses to make healthy lifestyle choices OBJECTIVES This study examined the effects of pricing and promotion strategies on purchases of low-fat snacks from vending machines . METHODS  Low-fat snacks were added to 55 vending machines in a convenience sample of 12 secondary schools and 12 worksites . Four pricing levels ( equal price , 10 % reduction , 25 % reduction , 50 % reduction ) and 3 promotional conditions ( none , low-fat label , low-fat label plus promotional sign ) were crossed in a Latin square design . Sales of low-fat vending snacks were measured continuously for the 12-month intervention . RESULTS Price reductions of 10 % , 25 % , and 50 % on low-fat snacks were associated with significant increases in low-fat snack sales ; percentages of low-fat snack sales increased by 9 % , 39 % , and 93 % , respectively . Promotional signage was independently but weakly associated with increases in low-fat snack sales . Average profits per machine were not affected by the vending interventions . CONCLUSIONS Reducing relative prices on low-fat snacks was effective in promoting lower-fat snack purchases from vending machines in both adult and adolescent population Background Shift work has been hypothesized as a risk factor for obesity . In this study , we investigated the association between current shift work and body mass index ( BMI ) among female nurses in Korea . The relationship between duration of shift work and BMI of the participants was also evaluated . Methods This cross-sectional survey evaluated participants in the Korean Nurses ’ Survey , conducted from October to December 2011 , using web-based self-administered question naires . A total of 9,989 nurses were included among 10,000 who registered on the survey web site ( 5,287 shift workers and 4,702 non-shift workers ) . Current shift workers were divided into tertiles of shift work duration ( 0.08–3.00 years , n = 1,732 ; 3.08–6.75 years , n = 1,731 ; and 6.83–38.00 years , n = 1,686 ) . The BMI thresholds of overweight and obesity were ≥23 kg/m2 and ≥25 kg/m2 , respectively . Data were analyzed using SPSS software . Results Mean participant age was 33.2 ± 8.6 years and the mean BMI was 20.9 ± 2.5 kg/m2 . There were statistically significant differences in current smoking status , regular drinking habit , dietary habits , regular exercise , sleep problems and self-perceived health status according to duration of shift work . The overall prevalence of overweight/obesity ( 18.6 % ) and obesity ( 7.4 % ) increased significantly as shift work duration increased from the lowest to highest tertile ( P for trend < 0.001 ) . Multivariate logistic regression analysis revealed no association between current shift work and BMI . However , after adjusting for potential confounders , the participants with the longest duration of shift work were 1.63 ( 95 % CI , 1.22–2.17 ) times more likely to be overweight or obese than those with the shortest duration . There was a significant positive association between obesity and shift work duration in the unadjusted analysis ; however , it was attenuated and no longer significant in the multivariate model . Conclusions The duration of shift work was positively associated with prevalence of overweight/obesity  in nurses in Korea . Although these findings need to be confirmed in prospect i ve studies , they suggest that special attention should be paid to female nurses with a long duration of shift work As part of the Harvard Cancer Prevention Program Project , we used a social context ual model of health behavior change to test an intervention targeting multiple risk-related behaviors in working-class , multiethnic population s. We examined the relationships between the social context ual factors in our conceptual model and changes in fruit and vegetable consumption from baseline to completion of intervention in health centers and small business studies . We analyzed change in fruit and vegetable consumption , measured at baseline and final assessment s by self-report , in 2 r and omized controlled prevention trials : 1 in small businesses ( n = 974 ) and 1 in health centers ( n = 1954 ) .  Stronger social networks , social norms that were more supportive , food sufficiency , and less household crowding were associated with greater change in fruit and vegetable intake . We also observed differences between our intervention sites . Social context can play an important role in promoting changes in fruit and vegetable consumption OBJECTIVE The present study aim ed to evaluate the knowledge and practice s of public-sector primary -care health professionals and final-year students regarding the role of  nutrition , physical activity and smoking cessation ( lifestyle modification ) in the management of chronic diseases of lifestyle within the public health-care sector . DESIGN A comparative cross-sectional descriptive quantitative study was conducted in thirty primary health-care facilities and four tertiary institutions offering medical and /or nursing programmes in Cape Town in the Western Cape Metropole . Stratified r and om sampling , based on geographical location , was used to select the health facilities while convenience sampling was used to select students at the tertiary institutions . A vali date d self-administered knowledge test was used to obtain data from the health professionals . RESULTS Differential lifestyle modification knowledge exists among both health professionals and students , with less than 10 % achieving the desired scores of 80 % or higher . The majority of health professionals seem to be promoting the theoretical concepts of lifestyle modification but experience difficulty in providing practical advice to patients . Of the health professionals evaluated , doctors appeared to have the best knowledge of lifestyle modification . Lack of time , lack of patient adherence and language barriers were given as the main barriers to providing lifestyle counselling . CONCLUSIONS The undergraduate curricula of medical and nursing students should include sufficient training on lifestyle modification , particularly practical advice on diet , physical activity and smoking cessation . Health professionals working at primary health-care facilities should be up date d by providing lifestyle modification education as part of continuing medical education BACKGROUND This report examines psychosocial factors related to selection of  healthful diets .  Underst and ing why people select healthful diets  can lead to rational design and evaluation of nutrition intervention programs . METHODS Data are from 16,287 respondents to the baseline survey for the Working Well Trial , a r and omized , controlled trial of worksite-based health promotion . The psychosocial constructs we measured were predisposing factors ( beliefs , perceived benefits , and motivation ; 5 items , Cronbach 's alpha = 0.65 ) and enabling factors ( barriers , norms , and social support ; 6 items , Cronbach 's alpha = 0.57 ) . The healthful diet outcomes were intakes of fat , fiber , and servings of fruits and vegetables ( from a food frequency question naire ) and intention and self-efficacy to decrease fat and increase fruits and vegetables . RESULTS Based on a 5-point scale ( 1 = low to 5 = high ) , the mean predisposing factor scale score was much higher than the enabling factor scale score ( 3.77 vs 2.50 , P < 0.001 ) . Comparing respondents in the highest category of the predisposing scale to those in the lowest , mean percentage of energy from fat was 22.4 % lower ( -9 percentage points ) , fiber was 85.2 % higher ( + 4.6 g/1,000 kcal ) , and fruits and vegetables were 100 % higher ( + 1.6 servings/day ) ( all trends , P < 0.001 ) . Associations were similar , but much weaker , for the enabling scale . Multiple regression models , which included covariates related to diet and the predisposing and enabling scales , explained a total of between 13 and 26 % of the variance in diet and intention to change diet . After control for covariates , the predisposing scale remained a significant and strong predictor of diet and intention to change diet but the enabling scale explained small and nonsignificant amounts of variance . CONCLUSIONS Predisposing factors are strong predictors of current diet and intention to change diet . Final results from the Working Well Trial will provide more information on whether enabling factors can be enhanced by intervention and whether these changes result in healthier eating patterns This article reports the effect of a  worksite cancer control intervention on aspects of the physical and social environment related to dietary and smoking behaviors of employees . Data are from 111 intervention and control worksites that participated in the Working Well Trial . Employee surveys and interviews with key organizational informants assessed environmental and normative changes relevant to nutrition and tobacco use . Results indicated significant effects of the intervention on all nutrition outcomes : access to healthy food , nutritional information at work , and social norms regarding dietary choice . Significant benefits were not found for smoking norms or smoking policies . However , changes occurred in both the control and intervention sites on these variables . This first large analysis of environmental and normative effects of a worksite intervention is consistent with the employee behavior change findings for the trial and serves as a model for future analyses of multilevel worksite health promotion programs Purpose To quantify the incidence of overweight and obesity in nursing professionals and assess nurses ' knowledge of obesity and associated health risks . Data sources A mailed survey to 4980 r and omly selected registered nurses from one state in each of six geographic regions . Response rate was 15.5 % ( n= 760 ) . Descriptive statistics were calculated for continuous variables ; categorical variables were summarized with frequency counts . Results The gr and mean body mass index ( BMI ) of nurses surveyed was 27.2 . Almost 54 % were overweight or obese . Fifty-three percent of these nurses report that they are overweight but lack the motivation to make lifestyle changes . Forty percent are unable to lose weight despite healthy diet and exercise habits . Only 26 % of respondents use BMI to make clinical judgments of overweight and obesity . Although 93 % of nurses acknowledge that overweight and obesity are diagnoses requiring intervention , 76 % do not pursue the topic with overweight and obese patients . Discussion Many nurses provide weight-related health information to the public . These data suggest that they may benefit from continuing education on obesity and its risks . Because 76 % of nurses do not pursue the topic of obesity with patients , they may benefit from education on pursuing sensitive topics during a professional encounter . Nurse practitioners may play a key role in the education of both patients and registered nurses 
    Output:
    
The majority of studies reported barriers to healthy eating related to adverse work schedules , individual barriers , aspects of the physical workplace environment and social eating practice s at work .
Few facilitators were reported .
Overall , studies found the workplace exerts a considerable negative influence on  nurses ' dietary intake .