***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: Developing an evidence base for making public health decisions will require using data from evaluation studies with r and omized and nonr and omized design s. Assessing individual studies and using studies in quantitative research syntheses require transparent reporting of the study , with sufficient detail and clarity to readily see differences and similarities among studies in the same area . The Consoli date d St and ards of Reporting Trials ( CONSORT ) statement provides guidelines for transparent reporting of r and omized clinical trials . We present the initial version of the Transparent Reporting of Evaluations with Nonr and omized Design s ( TREND ) statement . These guidelines emphasize the reporting of theories used and descriptions of intervention and comparison conditions , research design , and methods of adjusting for possible biases in evaluation studies that use nonr and omized design OBJECTIVE Numerous studies has shown that regular physical exercise can reduce musculoskeletal pain , but the optimal setting to achieve high adherence and effectiveness remains unknown . This study investigated the effect of workplace versus home-based physical exercise on musculoskeletal pain among healthcare workers . METHODS The r and omized controlled trial ( RCT ) comprised 200 female healthcare workers from 18 departments at 3 hospitals . Participants were r and omly allocated at the cluster level to ten weeks of : ( i ) workplace physical exercise ( WORK ) performed during working hours for 5 × 10 minutes per week and up to 5 group-based coaching sessions on motivation for regular physical exercise , or ( ii ) home-based physical exercise ( HOME ) performed during leisure time for 5 × 10 minutes per week . Both groups received ergonomic counseling on patient h and ling and use of lifting aides . Average pain intensity ( 0 - 10 scale ) in the low back and neck/shoulder was the primary outcome . RESULTS Per week , 2.2 ( SD 1.1 ) and 1.0 ( SD 1.2 ) training sessions were performed in WORK and HOME groups , respectively . Pain intensity , back muscle strength and use of analgesics improved more following WORK than HOME ( P<0.05 ) . Between-group differences at follow-up ( WORK versus HOME ) was -0.7 points for pain intensity [ 95 % confidence interval ( 95 % CI ) -1.0- -0.3 ] , 5.5 Nm for back muscle strength ( 95 % CI 2.0 - 9.0 ) , and -0.4 days per week for use of analgesics ( 95 % CI -0.7- -0.2 ) . The effect size for between-group differences in pain intensity was small ( Cohen 's d=0.31 ) . CONCLUSIONS Workplace physical exercise is more effective than home-based exercise in reducing musculoskeletal pain , increasing muscle strength and reducing the use of analgesics among healthcare workers Purpose To evaluate whether information and reassurance about low back pain ( LBP ) given to employees at the workplace could reduce sick leave . Methods A Cluster r and omized controlled trial with 135 work units of about 3,500 public sector employees in two Norwegian municipalities , r and omized into two intervention groups ; Education and peer support ( EPS ) ( n = 45 units ) , education and “ peer support and access to an outpatient clinic ” ( EPSOC ) ( n = 48 units ) , and a control group ( n = 42 units ) . Both interventions consisted of educational meetings based on a “ non-injury model ” and a “ peer adviser ” appointed by colleagues . Employees in the EPSOC  group had access to an outpatient clinic for medical examination and further education . The control group received no intervention . The main outcome was sick leave based on municipal records . Secondary outcomes were self-reported pain , pain related fear of movement , coping , and beliefs about LBP from survey data of 1,746 employees ( response rate about 50 % ) . Results EPS reduced sick leave by 7 % and EPSOC reduced sick leave by 4 % during the intervention year , while sick leave in the control group was increased by 7 % during the same period . Overall , Rate Ratios ( RR ) were statistically significant for EPSOC ( RR = .84 ( C.I = 0.71–.99 ) but not EPS ( RR = .92 ( C.I = 0.78–1.09 ) ) in a mixed Poisson regression analysis . Faulty beliefs about LBP were reduced in both intervention groups . Conclusions Educational meetings , combined with peer support and access to an outpatient clinic , were effective in reducing sick leave in public sector employees The aim of the present study was to compare the effect of increased aerobic capacity versus muscle strength rehabilitation of female hospital staff with long-lasting musculoskeletal back pain . Seventy-nine women agreed to participate in the intervention study . After a medical examination , 65 individuals were assigned to one of three balanced groups : Endurance training ( aerobic capacity promoting training : ET : n = 22 ) , strength promotion exercise ( SP : n = 24 ) or a control group ( CON : n = 19 ) . The active groups met twice a week for 60 minutes of exercise over 15 weeks . Aerobic capacity ( VO2max ) and musculoskeletal pain were measured immediately before ( T1 ) and after the intervention period ( T2 ) . Aerobic capacity significantly increased in the ET group , whereas no change was observed in the SP group , and a significant reduction was found in the CON group from T1 to T2 . Musculoskeletal pain was significantly reduced in both intervention groups , whereas minor changes were observed in the control group . Results from a 7-month follow-up ( T3 ) survey confirmed the beneficial effects of interventions on musculoskeletal pain . In conclusion , improved aerobic capacity appeared not to be a necessary mechanism in musculoskeletal back pain reduction Purpose . To report findings from Treatwell 5-a-Day process tracking . Design . Worksites were r and omly assigned to a minimal intervention control , worksite-only condition , or worksite-plus-family condition . Setting . Twenty-two small community health centers in Massachusetts . Subjects . Employees of the community health centers . Intervention . Both intervention conditions included the formation of employee advisory boards ; activities such as nutrition discussion s and taste tests targeting individual behavior change ; and point-of-purchase labeling as an environmental strategy . Worksite-plus-family sites incorporated activities such as family contests , campaigns , and picnics . Measures . Documentation of the number and type of activities for extent of implementation ; number of participants in activities for reach ; program awareness and participation from the follow-up employee survey ( n = 1306 , representing 76 % [ range , 56%–100 % ] of the sample ) ; change in fruit and vegetable consumption from a comparison between the follow-up and baseline surveys ( n = 1359 , representing 87 % [ range , 75%–100 % ] of the sample ) . Results . A higher number of activities per employee was significantly correlated with greater program awareness ( . 68 ; p = . 006 ) and greater change in fruit and vegetable consumption ( .55 ; p = .04 ) . Greater participation in activities was significantly correlated with greater awareness ( .67 ; p = .007 ) , higher participation ( .61 ; p = .02 ) , and increase in fruit and vegetable consumption . ( .55 ; p = .04 ) . Conclusions . These results provide quantitative indicators of a dose-response relationship between the number of intervention activities per employee and higher percentage of employee participation and observed increases in fruit and vegetable consumption OBJECTIVE Shift work is associated with adverse health outcomes , and an unhealthy diet may be a contributing factor . We compared diet quantity and quality between day and shift workers , and studied exposure-response relationships regarding frequency of night shifts and years of shift work . METHODS Cross-sectional general population data from the European Prospect i ve Investigation into Cancer and Nutrition-Netherl and s ( EPIC-NL ) cohort was used . Dietary intake was assessed in 1993 - 1997 among adults aged 20 - 70 years using a food frequency question naire . We calculated  energy intake  , the  Mediterranean Diet Score ( MDS ) and WHO-based Healthy Diet Indicator ( HDI ) . In 2011 - 2014 , we retrospectively identified 683 shift workers and 7173 day workers in 1993 - 1997 . Using multivariable-adjusted linear regression analysis , we estimated regression coefficients ( β ) and 95 % confidence intervals ( 95 % CI ) of the differences in dietary intake between day and shift workers . RESULTS Shift workers had a higher energy intake than day workers ( β:56 kcal/d , 95 % CI 10 - 101 ) , and a higher consumption of grains , dairy products , meat and fish ( P<0.05 ) . The difference in energy intake was largest for shift workers with ≥5 night shifts/month . They consumed 103 kcal/d ( 95 % CI 29 - 176 ) more than day workers . No associations were found with MDS and HDI . CONCLUSION Shift workers and particularly those with a high frequency of night shifts had a higher energy intake than day workers . Regardless of number of night shifts and years of shift work , shift workers had similar diet quality as day workers . This suggests that increased energy intake among shift workers may contribute to shift work-induced adverse health outcomes Background Increased physical activity levels benefit both an individuals ' health and productivity at work . The purpose of the current study was to explore the impact and cost-effectiveness of a workplace physical activity intervention design ed to increase physical activity levels . Methods A total of 1260 participants from 44 UK worksites ( based within 5 organizations ) were recruited to a cluster r and omized controlled trial with worksites r and omly allocated to an intervention or control condition . Measurement of physical activity and other variables occurred at baseline , and at 0 months , 3 months and 9 months post-intervention . Health outcomes were measured during a 30 minute health check conducted in worksites at baseline and 9 months post intervention . The intervention consisted of a 3 month tool-kit of activities targeting components of the Theory of Planned Behavior , delivered in-house by nominated facilitators . Self-reported physical activity ( measured using the IPAQ short-form ) and health outcomes were assessed . Results and discussion Multilevel modelling found no significant effect of the intervention on MET minutes of activity ( from the IPAQ ) at any of the follow-up time points controlling for baseline activity . However , the intervention did significantly reduce systolic blood pressure ( B = -1.79 mm/Hg ) and resting heart rate ( B = -2.08 beats ) and significantly increased body mass index ( B = .18 units ) compared to control . The intervention was found not to be cost-effective , however the substantial variability round this estimate suggested that further research is warranted . Conclusions The current study found mixed support for this worksite physical activity intervention . The paper discusses some of the tensions involved in conducting rigorous evaluations of large-scale r and omized controlled trials in real-world setting s . Trial registration Current controlled trials IS RCT Background Dietary behaviour interventions have the potential to reduce diet-related disease . Ample opportunity exists to implement these interventions in the workplace . The overall aim is to assess the effectiveness and cost-effectiveness of complex dietary interventions focused on environmental dietary modification alone or in combination with nutrition education in large manufacturing workplace setting s. Methods / design A clustered controlled trial involving four large multinational manufacturing workplaces in Cork will be conducted . The complex intervention design has been developed using the Medical Research Council ’s framework and the National Institute for Health and Clinical Excellence ( NICE ) guidelines and will be reported using the TREND statement for the transparent reporting of evaluations with non-r and omized design s. It will draw on a soft paternalistic “ nudge ” theoretical perspective . Nutrition education will include three elements : group presentations , individual nutrition consultations and detailed nutrition information . Environmental dietary modification will consist of five elements : ( a ) restriction of fat , saturated fat , sugar and salt , ( b ) increase in fibre , fruit and vegetables , ( c ) price discounts for whole fresh fruit , ( d ) strategic positioning of healthier alternatives and ( e ) portion size control . No intervention will be offered in workplace A ( control ) . Workplace B will receive nutrition education . Workplace C will receive nutrition education and environmental dietary modification . Workplace D will receive environmental dietary modification alone .  A total of 448 participants aged 18 to 64 years will be selected r and omly . All permanent , full-time employees , purchasing at least one main meal in the workplace daily , will be eligible .  Changes in dietary behaviours , nutrition knowledge , health status with measurements obtained at baseline and at intervals of 3 to 4 months , 7 to 9 months and 13 to 16 months will be recorded . A process evaluation and cost-effectiveness economic evaluation will be undertaken . Discussion A ' Food Choice at Work ’ toolbox ( concise teaching kit to replicate the intervention ) will be developed to inform and guide future research ers , workplace stakeholders , policy makers and the food industry . Trial registration Current Controlled Trials , IS RCT Background The prevalence and consequences of musculoskeletal pain is considerable among healthcare workers , allegedly due to high physical work dem and s of healthcare work . Previous investigations have shown promising results of physical exercise for relieving pain among different occupational groups , but the question remains whether such physical exercise should be performed at the workplace or conducted as home-based exercise . Performing physical exercise at the workplace together with colleagues may be more motivating for some employees and thus increase adherence . On the other h and , physical exercise performed during working hours at the workplace may be costly for the employers in terms of time spend . Thus , it seems relevant to compare the efficacy of workplace- versus home-based training on musculoskeletal pain . This study is intended to investigate the effect of workplace-based versus home-based physical exercise on musculoskeletal pain among healthcare workers . Methods / Design This study was design ed 
    Output:
    
There was moderate evidence for effectiveness on weight and physical activity outcomes , but insufficient evidence for healthy eating outcomes .
Conclusion Current evidence demonstrates that group-based workplace interventions can be effective for supporting shift workers to lose weight and increase physical activity , while further research is needed to change healthy eating and sedentary behaviors .