human
***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: Background Both low back pain ( LBP ) and neck pain ( NP ) are major occupational health problems . In the workplace , participatory ergonomics ( PE ) is frequently used on musculoskeletal disorders . However , evidence on the effectiveness of PE to prevent LBP and NP obtained from r and omised controlled trials ( RCTs ) is scarce . This study evaluates the process of the Stay@Work participatory ergonomics programme , including the perceived implementation of the prioritised ergonomic measures . Methods This cluster- RCT was conducted at the departments of four Dutch companies ( a railway transportation company , an airline company , a steel company , and a university including its university medical hospital ) . Directly after the r and omisation outcome , intervention departments formed a working group that followed the steps of PE during a six-hour working group meeting . Guided by an ergonomist , working groups identified and prioritised risk factors for LBP and NP , and composed and prioritised ergonomic measures . Within three months after the meeting , working groups had to implement the prioritised ergonomic measures at their department . Data on various process components ( recruitment , reach , fidelity , satisfaction , and implementation components , i.e. , dose delivered and dose received ) were collected and analysed on two levels : department ( i.e. , working group members from intervention departments ) and participant ( i.e. , workers from intervention departments ) . Results A total of 19 intervention departments ( n = 10 with mental workloads , n = 1 with a light physical workload , n = 4 departments with physical and mental workloads , and n = 4 with heavy physical workloads ) were recruited for participation , and the reach among working group members who participated was high ( 87 % ) . Fidelity and satisfaction towards the PE programme rated by the working group members was good ( 7.3 or higher ) . The same was found for the Stay@Work ergocoach training ( 7.5 or higher ) . In total , 66 ergonomic measures were prioritised by the working groups . Altogether , 34 % of all prioritised ergonomic measures were perceived as implemented ( dose delivered ) , while the workers at the intervention departments perceived 26 % as implemented ( dose received ) . Conclusions PE can be a successful method to develop and to prioritise ergonomic measures to prevent LBP and NP . Despite the positive rating of the PE programme the implementation of the prioritised ergonomic measures was lower than expected . Trial registration Current Controlled Trials IS RCT Background Effective interventions to influence workplace sitting are needed , as office-based workers demonstrate high levels of continued sitting , and sitting too much is associated with adverse health effects . Therefore , we developed a theory-driven , Web-based , interactive , computer-tailored intervention aim ed at reducing and interrupting sitting at work . Objective The objective of our study was to investigate the effects of this intervention on objective ly measured sitting time , st and ing time , and breaks from sitting , as well as self-reported context -specific sitting among Flemish employees in a field-based approach . Methods Employees ( n=213 ) participated in a 3-group r and omized controlled trial that assessed outcomes at baseline , 1-month follow-up , and 3-month follow-up through self-reports . A sub sample ( n=122 ) were willing to wear an activity monitor ( activPAL ) from Monday to Friday . The tailored group received an automated Web-based , computer-tailored intervention including personalized feedback and tips on how to reduce or interrupt workplace sitting . The generic group received an automated Web-based generic advice with tips . The control group was a wait-list control condition , initially receiving no intervention . Intervention effects were tested with repeated- measures multivariate analysis of variance . Results The tailored intervention was successful in decreasing self-reported total workday sitting ( time × group : P<.001 ) , sitting at work ( time × group : P<.001 ) , and leisure time sitting ( time × group : P=.03 ) , and in increasing objective ly measured breaks at work ( time × group : P=.07 ) ; this was not the case in the other conditions . The changes in self-reported total nonworkday sitting , sitting during transport , television viewing , and personal computer use , objective ly measured total sitting time , and sitting and st and ing time at work did not differ between conditions . Conclusions Our results point out the significance of computer tailoring for sedentary behavior and its potential use in public health promotion , as the effects of the tailored condition were superior to the generic and control conditions . Trial Registration Clinical trials.gov NCT02672215 ; http:// clinical trials.gov/ct2/show/NCT02672215 ( Archived by WebCite at http://www.webcitation.org/6glPFBLWv Background Arm , shoulder and neck symptoms are very prevalent among computer workers . In an attempt to reduce these symptoms , a large occupational health service in the Netherl and s developed a preventive programme on exposure to risk factors , prevalence of arm , shoulder and neck symptoms , and sick leave in computer workers . The purpose of this study was to assess the effectiveness of this intervention programme . Methods The study was a r and omised controlled trial . The participants were assigned to either the intervention group or the usual care group by means of cluster r and omisation . At baseline and after 12 months of follow-up , the participants completed the RSI QuickScan question naire on exposure to the risk factors and on the prevalence of arm , shoulder and neck symptoms . A tailor-made intervention programme was proposed to participants with a high risk profile at baseline . Examples of implemented interventions are an individual workstation check , a visit to the occupational health physician and an education programme on the prevention of arm , shoulder and neck symptoms . The primary outcome measure was the prevalence of arm , shoulder and neck symptoms . Secondary outcome measures were the scores on risk factors for arm , shoulder and neck symptoms and the number of days of sick leave . Sick leave data was obtained from the companies . Multilevel analyses were used to test the effectiveness . Results Of the 1,673 persons invited to participate in the study , 1,183 persons ( 71 % ) completed the baseline question naire and 741 persons participated at baseline as well as at 12-month follow-up . At 12-month follow-up , the intervention group showed a significant positive change ( OR = 0.48 ) in receiving information on healthy computer use , as well as a significant positive change regarding risk indicators for work posture and movement , compared to the usual care group . There were no significant differences in changes in the prevalence of arm , shoulder and neck symptoms or sick leave between the intervention and usual care group . Conclusions The effects of the RSI QuickScan intervention programme were small , possibly as a result of difficulties with the implementation process of the proposed interventions . However , some significant positive effects were found as to an increase in receiving education and a decrease in exposure to adverse postures and movements . With regard to symptoms and sick leave , only small and non-significant effects were found . Trial registration Netherl and s National Trial Register BACKGROUND This study exp and ed previous NIOSH-IRS research examining the effects of rest breaks and stretching exercises on symptoms and performance in data -entry workers . METHODS All workers spent 4 weeks with conventional breaks ( two 15 min breaks per day ) and 4 weeks with supplementary breaks ( two 15 min breaks plus four 5 min breaks per day ) . One-half were assigned at r and om to a group instructed to perform brief stretching exercises during breaks . The remainder comprised the " no stretching " ( control ) group . RESULTS 51 workers ( stretch group n = 21 ; no stretch group n = 30 ) completed the study symptom question naires . Discomfort and eyestrain were significantly lower with supplementary breaks , and supplementary breaks attenuated accumulation of discomfort and eyestrain during work sessions . Data -entry speed was significantly faster with supplementary breaks so that work output was maintained , despite replacing 20 min of work time with break time . In the stretch group , workers reported  stretching  during only 25 % of conventional breaks and 39 % of supplementary breaks , and no significant effects of stretching on discomfort or performance were observed . CONCLUSIONS These results provide further converging evidence that supplementary breaks reliably minimize discomfort and eyestrain without impairing productivity . Low compliance in performing stretches prevented valid assessment of stretching effects . Further research on stretching exercises and exercise compliance is warranted Background Low back pain ( LBP ) and neck pain ( NP ) are a major public health problem with considerable costs for individuals , companies and society . Therefore , prevention is imperative . The Stay@Work study investigates the (cost-)effectiveness of Participatory Ergonomics ( PE ) to prevent LBP and NP among workers . Methods In a r and omised controlled trial ( RCT ) , a total of 5,759 workers working at 36 departments of four companies is expected to participate in the study at baseline . The departments consisting of about 150 workers are pre-stratified and r and omised . The control departments receive usual practice and the intervention departments receive PE . Within each intervention department a working group is formed including eight workers , a representative of the management , and an occupational health and safety coordinator . During a one day meeting , the working group follows the steps of PE in which the most important risk factors for LBP and NP , and the most adequate ergonomic measures are identified on the basis of group consensus . The implementation of ergonomic measures at the department is performed by the working group . To improve the implementation process , so-called ' ergocoaches ' are trained . The primary outcome measure is an episode of LBP and NP . Secondary outcome measures are actual use of ergonomic measures , physical workload , psychosocial workload , intensity of pain , general health status , sick leave , and work productivity . The cost-effectiveness analysis is performed from the societal and company perspective . Outcome measures are assessed using question naires at baseline and after 6 and 12 months . Data on the primary outcome as well as on intensity of pain , sick leave , work productivity , and health care costs are collected every 3 months . Discussion Prevention of LBP and NP is beneficial for workers , employers , and society . If the intervention is proven (cost-)effective , the intervention can have a major impact on LBP and NP prevention and , thereby , on work disability prevention . Results are expected in 2010.Trial registration IS RCT Background Excessive sitting time is a risk factor for cardiovascular disease mortality and morbidity independent of physical activity . This aim of this study was to evaluate the impact of a sit-st and workstation on sitting time , and vascular , metabolic and musculoskeletal outcomes in office workers , and to investigate workstation acceptability and feasibility . Methods A two-arm , parallel-group , individually r and omised controlled trial was conducted in one organisation . Participants were asymptomatic full-time office workers aged ≥18 years . Each participant in the intervention arm had a sit-st and workstation installed on their workplace desk for 8 weeks . Participants in the control arm received no intervention . The primary outcome was workplace sitting time , assessed at 0 , 4 and 8 weeks by an ecological momentary assessment diary . Secondary behavioural , cardiometabolic and musculoskeletal outcomes were assessed . Acceptability and feasibility were assessed via question naire and interview . ANCOVA and magnitude-based inferences examined intervention effects relative to controls at 4 and 8 weeks . Participants and research ers were not blind to group allocation . Results Forty-seven participants were r and omised ( intervention n = 26 ; control n = 21 ) . Relative to the control group at 8 weeks , the intervention group had a beneficial decrease in sitting time ( −80.2 min/8-h workday ( 95 % CI = −129.0 , −31.4 ) ; p = 0.002 ) , increase in st and ing time ( 72.9 min/8-h workday ( 21.2 , 124.6 ) ; p = 0.007 ) and decrease in total cholesterol ( −0.40 mmol/L ( −0.79 , −0.003 ) ; p = 0.049 ) . No harmful changes in musculoskeletal discomfort/pain were observed relative to controls , and beneficial changes in flow-mediated dilation and diastolic blood pressure were observed . Most participants self-reported that the workstation was easy to use and their work-related productivity did not decrease when using the device . Factors that negatively influenced workstation use were workstation design , the social environment , work tasks and habits . ConclusionS hort-term use of a feasible sit-st and workstation reduced daily sitting time and led to beneficial improvements in cardiometabolic risk parameters in asymptomatic office workers . These findings imply that if the observed use of the sit-st and workstations continued over a longer duration , sit-st and workstations may have important ramifications for the prevention and reduction of cardiometabolic risk in a large proportion of the working population .Trial registration Clinical Trials.gov NCT02496507 Objectives Prolonged sitting at work has been found to increase risk for musculoskeletal pain . The office-based intervention " Take a St and ! " was effective in reducing sitting time at work . We aim ed to study the effect of the intervention on a secondary outcome : musculoskeletal pain . Methods Take a St and ! included 19 offices ( 317 workers ) at four workplaces cluster r and omized to intervention or control . The multicomponent intervention lasted three months and included management support , environmental changes , and local adaptation . Control participants behaved as usual . Musculoskeletal pain was measured by self-report question naire assessing pain in neck-shoulders , back and extremities in three categories at baseline , and one and three months follow-up . Results At one month , there was no difference in odds ratio ( OR ) for pain in neck-shoulders between the two groups . However , after three months , the OR was 0.52 [ 95 % confidence interval ( 95 % CI ) 0.30 - 0.92 ] for pain in neck-shoulders in the intervention compared to the control group . No differences were found between the intervention and control group for pain in back and extremities over the three 
    Output:
    
agent
We found inconsistent evidence that the use of an arm support or an alternative mouse may or may not reduce the incidence of neck or shoulder MSDs .
For other physical ergonomic interventions there is no evidence of an effect .
For organisational interventions , in the form of supplementary breaks , there is very low- quality evidence of an effect on upper limb discomfort .
For training and multifaceted interventions there is no evidence of an effect on upper limb pain or discomfort .
***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: Background Both low back pain ( LBP ) and neck pain ( NP ) are major occupational health problems . In the workplace , participatory ergonomics ( PE ) is frequently used on musculoskeletal disorders . However , evidence on the effectiveness of PE to prevent LBP and NP obtained from r and omised controlled trials ( RCTs ) is scarce . This study evaluates the process of the Stay@Work participatory ergonomics programme , including the perceived implementation of the prioritised ergonomic measures . Methods This cluster- RCT was conducted at the departments of four Dutch companies ( a railway transportation company , an airline company , a steel company , and a university including its university medical hospital ) . Directly after the r and omisation outcome , intervention departments formed a working group that followed the steps of PE during a six-hour working group meeting . Guided by an ergonomist , working groups identified and prioritised risk factors for LBP and NP , and composed and prioritised ergonomic measures . Within three months after the meeting , working groups had to implement the prioritised ergonomic measures at their department . Data on various process components ( recruitment , reach , fidelity , satisfaction , and implementation components , i.e. , dose delivered and dose received ) were collected and analysed on two levels : department ( i.e. , working group members from intervention departments ) and participant ( i.e. , workers from intervention departments ) . Results A total of 19 intervention departments ( n = 10 with mental workloads , n = 1 with a light physical workload , n = 4 departments with physical and mental workloads , and n = 4 with heavy physical workloads ) were recruited for participation , and the reach among working group members who participated was high ( 87 % ) . Fidelity and satisfaction towards the PE programme rated by the working group members was good ( 7.3 or higher ) . The same was found for the Stay@Work ergocoach training ( 7.5 or higher ) . In total , 66 ergonomic measures were prioritised by the working groups . Altogether , 34 % of all prioritised ergonomic measures were perceived as implemented ( dose delivered ) , while the workers at the intervention departments perceived 26 % as implemented ( dose received ) . Conclusions PE can be a successful method to develop and to prioritise ergonomic measures to prevent LBP and NP . Despite the positive rating of the PE programme the implementation of the prioritised ergonomic measures was lower than expected . Trial registration Current Controlled Trials IS RCT Background Effective interventions to influence workplace sitting are needed , as office-based workers demonstrate high levels of continued sitting , and sitting too much is associated with adverse health effects . Therefore , we developed a theory-driven , Web-based , interactive , computer-tailored intervention aim ed at reducing and interrupting sitting at work . Objective The objective of our study was to investigate the effects of this intervention on objective ly measured sitting time , st and ing time , and breaks from sitting , as well as self-reported context -specific sitting among Flemish employees in a field-based approach . Methods Employees ( n=213 ) participated in a 3-group r and omized controlled trial that assessed outcomes at baseline , 1-month follow-up , and 3-month follow-up through self-reports . A sub sample ( n=122 ) were willing to wear an activity monitor ( activPAL ) from Monday to Friday . The tailored group received an automated Web-based , computer-tailored intervention including personalized feedback and tips on how to reduce or interrupt workplace sitting . The generic group received an automated Web-based generic advice with tips . The control group was a wait-list control condition , initially receiving no intervention . Intervention effects were tested with repeated- measures multivariate analysis of variance . Results The tailored intervention was successful in decreasing self-reported total workday sitting ( time × group : P<.001 ) , sitting at work ( time × group : P<.001 ) , and leisure time sitting ( time × group : P=.03 ) , and in increasing objective ly measured breaks at work ( time × group : P=.07 ) ; this was not the case in the other conditions . The changes in self-reported total nonworkday sitting , sitting during transport , television viewing , and personal computer use , objective ly measured total sitting time , and sitting and st and ing time at work did not differ between conditions . Conclusions Our results point out the significance of computer tailoring for sedentary behavior and its potential use in public health promotion , as the effects of the tailored condition were superior to the generic and control conditions . Trial Registration Clinical trials.gov NCT02672215 ; http:// clinical trials.gov/ct2/show/NCT02672215 ( Archived by WebCite at http://www.webcitation.org/6glPFBLWv Background Arm , shoulder and neck symptoms are very prevalent among computer workers . In an attempt to reduce these symptoms , a large occupational health service in the Netherl and s developed a preventive programme on exposure to risk factors , prevalence of arm , shoulder and neck symptoms , and sick leave in computer workers . The purpose of this study was to assess the effectiveness of this intervention programme . Methods The study was a r and omised controlled trial . The participants were assigned to either the intervention group or the usual care group by means of cluster r and omisation . At baseline and after 12 months of follow-up , the participants completed the RSI QuickScan question naire on exposure to the risk factors and on the prevalence of arm , shoulder and neck symptoms . A tailor-made intervention programme was proposed to participants with a high risk profile at baseline . Examples of implemented interventions are an individual workstation check , a visit to the occupational health physician and an education programme on the prevention of arm , shoulder and neck symptoms . The primary outcome measure was the prevalence of arm , shoulder and neck symptoms . Secondary outcome measures were the scores on risk factors for arm , shoulder and neck symptoms and the number of days of sick leave . Sick leave data was obtained from the companies . Multilevel analyses were used to test the effectiveness . Results Of the 1,673 persons invited to participate in the study , 1,183 persons ( 71 % ) completed the baseline question naire and 741 persons participated at baseline as well as at 12-month follow-up . At 12-month follow-up , the intervention group showed a significant positive change ( OR = 0.48 ) in receiving information on healthy computer use , as well as a significant positive change regarding risk indicators for work posture and movement , compared to the usual care group . There were no significant differences in changes in the prevalence of arm , shoulder and neck symptoms or sick leave between the intervention and usual care group . Conclusions The effects of the RSI QuickScan intervention programme were small , possibly as a result of difficulties with the implementation process of the proposed interventions . However , some significant positive effects were found as to an increase in receiving education and a decrease in exposure to adverse postures and movements . With regard to symptoms and sick leave , only small and non-significant effects were found . Trial registration Netherl and s National Trial Register BACKGROUND This study exp and ed previous NIOSH-IRS research examining the effects of rest breaks and stretching exercises on symptoms and performance in data -entry workers . METHODS All workers spent 4 weeks with conventional breaks ( two 15 min breaks per day ) and 4 weeks with supplementary breaks ( two 15 min breaks plus four 5 min breaks per day ) . One-half were assigned at r and om to a group instructed to perform brief stretching exercises during breaks . The remainder comprised the " no stretching " ( control ) group . RESULTS 51 workers ( stretch group n = 21 ; no stretch group n = 30 ) completed the study symptom question naires . Discomfort and eyestrain were significantly lower with supplementary breaks , and supplementary breaks attenuated accumulation of discomfort and eyestrain during work sessions . Data -entry speed was significantly faster with supplementary breaks so that work output was maintained , despite replacing 20 min of work time with break time . In the stretch group , workers reported  stretching  during only 25 % of conventional breaks and 39 % of supplementary breaks , and no significant effects of stretching on discomfort or performance were observed . CONCLUSIONS These results provide further converging evidence that supplementary breaks reliably minimize discomfort and eyestrain without impairing productivity . Low compliance in performing stretches prevented valid assessment of stretching effects . Further research on stretching exercises and exercise compliance is warranted Background Low back pain ( LBP ) and neck pain ( NP ) are a major public health problem with considerable costs for individuals , companies and society . Therefore , prevention is imperative . The Stay@Work study investigates the (cost-)effectiveness of Participatory Ergonomics ( PE ) to prevent LBP and NP among workers . Methods In a r and omised controlled trial ( RCT ) , a total of 5,759 workers working at 36 departments of four companies is expected to participate in the study at baseline . The departments consisting of about 150 workers are pre-stratified and r and omised . The control departments receive usual practice and the intervention departments receive PE . Within each intervention department a working group is formed including eight workers , a representative of the management , and an occupational health and safety coordinator . During a one day meeting , the working group follows the steps of PE in which the most important risk factors for LBP and NP , and the most adequate ergonomic measures are identified on the basis of group consensus . The implementation of ergonomic measures at the department is performed by the working group . To improve the implementation process , so-called ' ergocoaches ' are trained . The primary outcome measure is an episode of LBP and NP . Secondary outcome measures are actual use of ergonomic measures , physical workload , psychosocial workload , intensity of pain , general health status , sick leave , and work productivity . The cost-effectiveness analysis is performed from the societal and company perspective . Outcome measures are assessed using question naires at baseline and after 6 and 12 months . Data on the primary outcome as well as on intensity of pain , sick leave , work productivity , and health care costs are collected every 3 months . Discussion Prevention of LBP and NP is beneficial for workers , employers , and society . If the intervention is proven (cost-)effective , the intervention can have a major impact on LBP and NP prevention and , thereby , on work disability prevention . Results are expected in 2010.Trial registration IS RCT Background Excessive sitting time is a risk factor for cardiovascular disease mortality and morbidity independent of physical activity . This aim of this study was to evaluate the impact of a sit-st and workstation on sitting time , and vascular , metabolic and musculoskeletal outcomes in office workers , and to investigate workstation acceptability and feasibility . Methods A two-arm , parallel-group , individually r and omised controlled trial was conducted in one organisation . Participants were asymptomatic full-time office workers aged ≥18 years . Each participant in the intervention arm had a sit-st and workstation installed on their workplace desk for 8 weeks . Participants in the control arm received no intervention . The primary outcome was workplace sitting time , assessed at 0 , 4 and 8 weeks by an ecological momentary assessment diary . Secondary behavioural , cardiometabolic and musculoskeletal outcomes were assessed . Acceptability and feasibility were assessed via question naire and interview . ANCOVA and magnitude-based inferences examined intervention effects relative to controls at 4 and 8 weeks . Participants and research ers were not blind to group allocation . Results Forty-seven participants were r and omised ( intervention n = 26 ; control n = 21 ) . Relative to the control group at 8 weeks , the intervention group had a beneficial decrease in sitting time ( −80.2 min/8-h workday ( 95 % CI = −129.0 , −31.4 ) ; p = 0.002 ) , increase in st and ing time ( 72.9 min/8-h workday ( 21.2 , 124.6 ) ; p = 0.007 ) and decrease in total cholesterol ( −0.40 mmol/L ( −0.79 , −0.003 ) ; p = 0.049 ) . No harmful changes in musculoskeletal discomfort/pain were observed relative to controls , and beneficial changes in flow-mediated dilation and diastolic blood pressure were observed . Most participants self-reported that the workstation was easy to use and their work-related productivity did not decrease when using the device . Factors that negatively influenced workstation use were workstation design , the social environment , work tasks and habits . ConclusionS hort-term use of a feasible sit-st and workstation reduced daily sitting time and led to beneficial improvements in cardiometabolic risk parameters in asymptomatic office workers . These findings imply that if the observed use of the sit-st and workstations continued over a longer duration , sit-st and workstations may have important ramifications for the prevention and reduction of cardiometabolic risk in a large proportion of the working population .Trial registration Clinical Trials.gov NCT02496507 Objectives Prolonged sitting at work has been found to increase risk for musculoskeletal pain . The office-based intervention " Take a St and ! " was effective in reducing sitting time at work . We aim ed to study the effect of the intervention on a secondary outcome : musculoskeletal pain . Methods Take a St and ! included 19 offices ( 317 workers ) at four workplaces cluster r and omized to intervention or control . The multicomponent intervention lasted three months and included management support , environmental changes , and local adaptation . Control participants behaved as usual . Musculoskeletal pain was measured by self-report question naire assessing pain in neck-shoulders , back and extremities in three categories at baseline , and one and three months follow-up . Results At one month , there was no difference in odds ratio ( OR ) for pain in neck-shoulders between the two groups . However , after three months , the OR was 0.52 [ 95 % confidence interval ( 95 % CI ) 0.30 - 0.92 ] for pain in neck-shoulders in the intervention compared to the control group . No differences were found between the intervention and control group for pain in back and extremities over the three 
    Output:
    