***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: CONTEXT Workplace stress and burnout are pervasive problems , affecting employee performance and personal health . OBJECTIVE To evaluate the effects of the Transcendental Meditation program on psychological distress and burnout among staff at a residential therapeutic school for students with severe behavioral problems . DESIGN A total of 40 secondary schoolteachers and support staff at the Bennington School in Vermont , a therapeutic school for children with behavioral problems , were r and omly assigned to either practice of the Transcendental Meditation program or a wait-list control group . The Transcendental Meditation course was provided by certified instructors . MAIN OUTCOME MEASURES Outcome measures were assessed at baseline and four months , and included perceived stress , depression , and burnout . A multivariate analysis of covariance was used to determine overall effects . RESULTS Analysis of the 4-month intervention data indicated a significant improvement in the main outcomes of the study result ing from practice of the Transcendental Meditation program compared with controls ( Wilks Λ [ 3,28 ] = 0.695 ; p = 0.019 ) . Results of univariate F tests indicated a significant reduction of all main outcome measures : perceived stress ( F[1,32 ] = 13.42 ; p = < 0.001 ) ; depression ( F[1,32 ] = 6.92 ; p = 0.013 ) ; and overall teacher burnout ( F[1,32 ] = 6.18 ; p = 0.018 ) . Effect sizes ranged from 0.40 to 0.94 . CONCLUSIONS The Transcendental Meditation program was effective in reducing psychological distress in teachers and support staff working in a therapeutic school for students with behavioral problems . These findings have important implication s for employees ’ job performance as well as their mental and physical health INTRODUCTION Office employees are exposed to hazardous levels of sedentary work . Interventions that integrate health promotion and health protection elements are needed to advance the health of sedentary workers . This study tested an integrated intervention on occupational sedentary/physical activity behaviors , cardiometabolic disease biomarkers , musculoskeletal discomfort , and work productivity . DESIGN Two-group , RCT . Data were collected between January and August 2014 . SETTING / PARTICIPANTS Overweight/obese adults working in sedentary desk jobs were r and omized to : ( 1 ) a health protection-only group ( HPO , n=27 ) ; or ( 2 ) an integrated health protection/health promotion group ( HP/HP , n=27 ) . INTERVENTION HPO participants received an ergonomic workstation optimization intervention and three e-mails/week promoting rest breaks and posture variation . HP/HP participants received the HPO intervention plus access to a seated activity permissive workstation . MAIN OUTCOME MEASURES Occupational sedentary and physical activity behaviors ( primary outcomes ) , cardiometabolic health outcomes , musculoskeletal discomfort , and work productivity ( secondary outcomes ) were measured at baseline and post-intervention ( 16 weeks ) . RESULTS The HP/HP group increased occupational light intensity physical activity over the HPO group and used the activity permissive workstations 50 minutes/work day . Significant associations were observed between activity permissive workstation adherence and improvements in several cardiometabolic biomarkers ( weight , total fat mass , resting heart rate , body fat percentage ) and work productivity outcomes ( concentration at work , days missed because of health problems ) . CONCLUSIONS The HP/HP group increased occupational physical activity and greater activity permissive workstation adherence was associated with improved health and work productivity outcomes . These findings are important for employers interested in advancing the well-being of sedentary office workers . TRIAL REGISTRATION This study is registered at www . clinical trials.gov NCT02071420 Objective : The aim of this study was to determine the efficacy of a multimodal h and hygiene intervention program in reducing health care insurance cl aims for hygiene preventable infections ( eg , cold and influenza ) , absenteeism , and subjective impact on employees . Methods : A 13.5-month prospect i ve , r and omized cluster controlled trial was executed with  alcohol-based h and sanitizer in strategic workplace locations and personal use ( intervention group ) and brief h and hygiene education ( both groups ) . Four years of retrospective data were collected for all participants . Results : Hygiene-preventable health care cl aims were significantly reduced in the intervention group by over 20 % ( P < 0.05 ) . Absenteeism was positively impacted overall for the intervention group . Employee survey data showed significant improvements in h and hygiene behavior and perception of company concern for employee well-being . Conclusion : Providing a comprehensive , targeted , yet simple to execute h and hygiene program significantly reduced the incidence of health care cl aims and increased employee workplace satisfaction This study examined whether a group intervention focusing on building up preparedness for career management can prevent future sickness absence . Register-based data on the number of sickness absence days and sickness absence episodes were examined as outcomes of the intervention among 684 employees in 17 organizations in a r and omized controlled trial .  Sickness absence data were collected covering a period from 1 year before ( baseline ) to approximately 2 years after the intervention ( follow-up ) . The data were analyzed using zero-inflated negative binomial models . After controlling for baseline absence , age , gender , and organization , the intervention was effective in decreasing the number of longer sickness absences ( lasting longer than > 2 weeks ) , but no other significant effects were found . These findings point out that it is feasible to use a career management intervention to prevent future sickness absence in work organizations Objective : To investigate whether an exercise intervention shown to increase aerobic capacity , would also lead to less musculoskeletal pain ; improved work ability , productivity , and perceived physical exertion ; and less sick leave . Methods : Sixty-seven construction workers were r and omized into an exercise group training 3 × 20 minutes per week and a control group . Question naires and text messages were completed before and after the 12-week intervention . Results : No significant changes were found in musculoskeletal pain , work ability , productivity , perceived physical exertion , and sick leave with the intervention . Question naires and text messages provided similar results of pain and work ability . Conclusions : Although the intervention improved aerobic capacity , it was not successful in improving musculoskeletal pain and other work-related factors . A detectable improvement presumably requires a more multifaceted intervention , larger sample size , or longer follow-up . Text messages may be a convenient data - collection method in future studies OBJECTIVES Efforts to improve performance in the workplace with respect to positive mental health have increased , and cognitive behavioral therapy ( CBT ) has recently attracted attention as an intervention measure to this end . Here , we conducted a r and omized controlled trial to evaluate the effectiveness of a brief training program on CBT for improving  work performance  of employees .  METHODS The participants were employees of an electric company in Japan . The intervention consisted of 1 group session of CBT ( 120 min ) and web-based CBT homework for 1 month . We evaluated employees in both the intervention and control groups at baseline and follow-up after three months . The main outcome was work performance , which was evaluated by a subjective score from 1 to 10 . The secondary outcome was self-evaluation of cognitive flexibility . Analyses were conducted based on ITT . RESULTS In the intervention group , 84 participants attended the group session , with 79 subsequently completing at least 1 instance of online homework . ITT analysis showed that the subjective performance of the intervention group was significantly improved compared with that of the control group ( 1.47 vs. 0.69 , mean difference 0.78 [ 95 % confidence interval { CI } , 0.05 to 1.51 ] , Cohen 's d=0.31 ) . The ability to recognize dysfunctional thinking patterns and change them to positive ones significantly improved in the intervention group compared to the control group ( 0.71 vs. 0.26 , mean difference 0.45 [ 95 % CI 0.06 to 0.83 ] , d=0.33 ) . However , after adjustment for baseline scores , no significant difference was observed . The ability to view a situation from multiple perspectives and exp and one 's repertoire of thought patterns in the intervention group also significantly improved ( 0.83 vs. 0.35 , mean difference 0.48 [ 95 % CI 0.35 to 0.95 ] , d=0.29 ) , but here again , significance was lost after adjusting for baseline scores . DISCUSSION Our results suggest that a brief training program that combines a group CBT session with web-based CBT homework improved subjective work performance . In addition , this program might help improve employees ' cognitive flexibility This study examined whether a group intervention focusing on building up preparedness for career management can prevent future sickness absence . Register-based data on the number of sickness absence days and sickness absence episodes were examined as outcomes of the intervention among 684 employees in 17 organizations in a r and omized controlled trial .  Sickness absence data were collected covering a period from 1 year before ( baseline ) to approximately 2 years after the intervention ( follow-up ) . The data were analyzed using zero-inflated negative binomial models . After controlling for baseline absence , age , gender , and organization , the intervention was effective in decreasing the number of longer sickness absences ( lasting longer than > 2 weeks ) , but no other significant effects were found . These findings point out that it is feasible to use a career management intervention to prevent future sickness absence in work organizations Objective : Prolonged office sitting time adversely affects neuromuscular and cardiovascular health parameters . As a consequence , the present study investigated the effects of prompting the use of height-adjustable working desk ( HAWD ) on occupational sitting and st and ing time , neuromuscular outcomes and concentration in office workers . Methods : A single-blinded r and omized controlled trial ( RCT ) with parallel group design was conducted . Thirty-eight office workers were supplied with HAWDs and r and omly assigned ( Strata : physical activity ( PA ) , BMI , gender , workload ) to a prompt ( INT ) or non-prompt ( CON ) group . INT received three daily screen-based prompts within 12 weeks . CON was only instructed once concerning the benefits of using HAWDs prior to the start of the study . Sitting and st and ing times were objective ly assessed as primary outcomes for one entire working week using the ActiGraph wGT3X-BT at baseline ( pre ) , after 6 ( mid ) and 12 weeks ( post ) . Concentration ( d2-test ) , postural sway during upright stance ( under single , dual and triple task ) and lower limb strength endurance ( heel-rise ) were collected as secondary outcomes . Results : With large but not statistically significant within group effects from pre to post , INT increased weekly st and ing time at work by 9 % ( p = 0.22 , d = 0.8 ) representing an increase from 7.2 h ( 4.8 ) to 9.7 ( 6.6 ) h ( p = 0.07 ) . Concentration and neuromuscular performance did not change from pre to post testing ( 0.23 < p < 0.95 ; 0.001 < ηp² < 0.05 ) . Conclusion : Low-frequent and low cost screen-based point of choice prompts ( 3 per day within 12 weeks ) already result in notable increases of occupational st and ing time of approx . daily 30 min . These stimuli , however , did not relevantly affect neuromuscular 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 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 inter 
    Output:
    
The workplace is an interesting environment to reduce absenteeism , and individualized and counseling interventions with < 10 sessions/total were the most effective workplace intervention method ological design for reducing the absenteeism of employees .