Active versus passive distraction for reducing procedural pain and anxiety in children: a meta-analysis and systematic review.

BACKGROUND: Procedural pain is very important in clinical children care. We aimed to evaluate the effects of active versus passive distraction for reducing procedural pain and anxiety in children. METHODS: Two researchers searched the Web of Science, PubMed, EMBASE, Cochrane, SinoMed, Wanfang, China National Knowledge Infrastructure, Weipu databases for the randomized controlled trials(RCTs) on the active versus passive distraction affecting procedural pain and anxiety in children until May 18, 2023. The literature screening and data extraction were carried out by two researchers independently. Review Manager 5.3 software was used for data analysis. RESULTS: 13 RCTs were finally included. 553 children received active distraction intervention and 551 children received passive distraction intervention. There were no significant differences in the children self-reported procedural pain betweent active and passive distraction. The parent-reported procedural pain, medical staff-reported procedural pain, children-reported procedural anxiety, parent-reported procedural anxiety, medical staff-reported procedural anxiety in the active distraction were significant less than that of active distraction. Egger regression analysis showed that there was no publication bias in the results. CONCLUSIONS: Existing evidence suggests that active distraction may be more effective in reducing operational pain and anxiety in children than passive distraction. More studies on the effects of active distraction versus passive distraction in children with larger sample size are needed in the future.

The interaction of occupational stress, mental health, and cytokine levels on sleep in Xinjiang oil workers: A cross-sectional study.

Background: Sleep occupies one third of a person's life, and good sleep quality is an important factor to ensure good health. Purpose: This study investigated and analyzed the occupational stress, mental health and sleep quality of oil workers, analyzed the effects of occupational stress and mental health on sleep, and explored the effects of the interaction between occupational stress, mental health and cytokines on sleep. Materials and methods: In this study, stratified cluster random sampling was used to conduct a cross-sectional survey on the occupational stress, mental health and sleep quality of 1,141 oil workers in the Occupational Health Examination Department of Karamay Central Hospital, from June 2019 to January 2020, and 30% of the participants were randomly selected for measurement of their cytokine levels: interleukin 2 (IL-2), interleukin 6 (IL-6), interleukin 8 (IL-8), and tumor necrosis factor α (TNF-α). The objectives were to analyze the effects of occupational stress and mental health on sleep quality, and to explore the effects of occupational stress, mental disorders and cytokine interactions on sleep. Results: There were 646 individuals (56.6%) who suffered from sleep disorders; the incidence of sleep disorders differed according to sex, age, professional title, working years, type of work and shift (P < 0.05). The scores for occupational stress, mental health, and sleep quality were positively correlated (P < 0.05). Multivariate logistic regression analysis showed that age (30-45 years) (OR = 1.753, 95% CI: 1.067-2.881), junior college and above (OR = 1.473, 95% CI: 1.025-2.118), borehole operation (OR = 2.689, 95% CI: 1.508-4.792), extraction of oil (OR = 2.405, 95% CI: 1.229-4.705), drilling (OR = 1.791, 95% CI: 1.017-3.155), shift work (OR = 2.144, 95% CI: 1.615-2.846), occupational stress (OR = 1.007, 95% CI: 1.002-1.013), and mental disorders (OR = 1.020, 95% CI: 1.009-1.032) are risk factors for sleep disorders. In the high occupational stress group and the mental disorders group as the control group, the results showed that the interaction between IL-2 and moderate occupational stress (OR = 0.778, 95% CI: 0.778-0.942), IL-2 and non-mental disorders (OR = 0.398, 95% CI: 0.398-0.468) were protective factors for the occurrence of sleep disorders. The results of structural equation modeling analysis showed that occupational stress and mental health had positive predictive effects on IL-2 level and sleep quality [normalized path coefficients (ß) were 0.10\0.06\0.05\0.71, respectively]. Occupational stress had a direct positive predictive effect on mental disorder (ß = 0.25), and sleep disorder had a direct negative predictive effect on IL-2 concentration (ß = -0.21). Conclusion: Oil workers have serious sleep problems, so effective measures should be taken to reduce occupational stress and relieve mental health problems, and cytokine levels can be used as a predictor of sleep disorders.

Associations of musculoskeletal disorders with occupational stress and mental health among coal miners in Xinjiang, China: a cross-sectional study.

BACKGROUND: Musculoskeletal disorders (MSDs), a common type of occupational diseases, have become the main cause of absenteeism and early retirement in the occupational population, as well as a major risk factor for occupational disability. The purpose of this study was to investigate the effects of occupational stress and mental health on MSDs in coal miners in Xinjiang, China, to provide a theoretical basis for reducing the incidence of MSDs in coal miners and improving their physical and mental health. METHODS: In this study, stratified cluster random sampling was used to randomly select six coal mining companies in Xinjiang, and 1675 coal miners were surveyed by questionnaire. The status of occupational stress, mental health and MSDs among coal miners was investigated by means of the Effort-Reward Imbalance questionnaire (ERI), Symptom Checklist-90(SCL-90), and Musculoskeletal disorders scale (MSDs) questionnaire. RESULTS: The prevalence of MSDs among coal miners was higher, and there were statistical differences among different sexes, ages, working years, shifts, types of work, educational level and monthly income (P < 0.001). The prevalence of MSDs in different body parts in the occupational stress group and mental disorder group was higher than that in the normal group. The results of multivariate logistic regression analysis showed that females had an increased risk of developing MSDs (OR = 2.23, 95% CI.:1.50,3.33). The risk of MSDs was higher with age < 30 years (30-39 years,OR = 2.39, 95% CI.,1.68,3.40; 40-49 years,OR = 2.15, 95% CI.:1.52,3.04; 50-60 years:OR = 3.25, 95% CI.:2.09,5.07), and the longer the working years, the higher the risk of MSDs (OR = 1.90, 95% CI.:1.38,2.62). The two shifts group (OR = 2.18, 95% CI.:1.59,2.98) had an increased risk of developing MSDs compared with the fixed day shift group. The risk of MSDs was lower in heading drivers (OR = 0.41, 95% CI.:0.29,0.60,) and transport workers (OR = 0.30, 95% CI.:0.20,0.43). The higher the education level, the lower the risk of MSDs (high school: OR = 0.46, 95% CI.:0.34,0.62, junior college and above: OR = 0.12, 95% CI.:0.08,0.17), and the higher the monthly income, the lower the risk of MSDs (OR = 0.50, 95% CI.:0.34,0.74). Occupational stress (OR = 1.32, 95% CI.:1.05,1.67) and mental disorder(OR = 2.94, 95% CI.:2.25,3.84) increased the risk of MSDs. A Bayesian network diagram showed that occupational stress and MSDs have direct effects on mental disorders, and occupational stress can have indirect effects on mental disorders through MSDs. CONCLUSION: Our research shows that MSDs are common among coal miners. Occupational stress and psychological disorders can increase the incidence of MSDs.

Tracing copper derived from pig manure in calcareous soils and soil leachates by 65Cu labeling.

Copper is used as a growth promoter in animal husbandry, resulting in high Cu concentrations in animal manure. We tested whether Cu would be mobilized in soils receiving excessive loads of manure, both from recently added and from aged fractions. To discriminate between these Cu sources, manure was labeled with (65)Cu. After soil application of 0, 15, and 30 Mg manure ha(-1), leachate was collected in free-draining lysimeters (40 cm depth) under undisturbed soil over a 53 day period. Determining the total amounts of Cu and the fractions of (65)Cu in leachate and the soil profile enabled us to trace the translocation of Cu derived from labeled manure. More than 84% of the applied Cu was retained in the top 2 cm of soil. Less than 0.01% of the applied Cu was detected overall in the leachate. Of this amount, however, 38% (± 8.9 SE) was leached within 8 days after application. The total Cu concentration in leachates (32-164 µg L(-1)) frequently exceeded the Chinese groundwater quality standard of 50 µg L(-1). The added (65)Cu, however, accounted for less than 3.6% of the total Cu leaching load, suggesting that Cu from older sources and/or geological background controls contamination, regardless of current land management.

Identification of soil contamination hotspots with veterinary antibiotics using heavy metal concentrations and leaching data--a field study in China.

In regions with high livestock densities, the usage of antibiotics and metals for veterinary purposes or as growth promoters poses a risk in manured soils. We investigated to which degree the concentrations and depth distributions of Cu, Zn, Cr and As could be used as a tracer to discover contaminations with sulfonamides, tetracyclines and fluoroquinolones. Besides, we estimated the potential vertical translocation of antibiotics and compared the results to measured data. In the peri-urban region of Beijing, China, soil was sampled from agricultural fields and a dry riverbed contaminated by organic waste disposal. The antibiotic concentrations reached 110 µg kg(-1) sulfamethazine, 111 µg kg(-1) chlortetracycline and 62 µg kg(-1) enrofloxacin in the topsoil of agricultural fields. Intriguingly, total concentrations of Cu, Zn, Cr and As were smaller than 65, 130, 36 and 10 mg kg(-1) in surface soil, respectively, therewith fulfilling Chinese quality standards. Correlations between sulfamethazine concentrations and Cu or Zn suggest that in regions with high manure applications, one might use the frequently existing monitoring data for metals to identify potential pollution hotspots for antibiotics in topsoils. In the subsoils, we found sulfamethazine down to ≥2 m depth on agricultural sites and down to ≥4 m depth in the riverbed. As no translocation of metals was observed, subsoil antibiotic contamination could not be predicted from metal data. Nevertheless, sulfonamide stocks in the subsoil could be estimated with an accuracy of 35-200 % from fertilisation data and potential leaching rates. While this may not be sufficient for precise prediction of antibiotic exposure, it may very well be useful for the pre-identification of risk hotspots for subsequent in-depth assessment studies.

Deriving sorption indices for the prediction of potential phosphorus loss from calcareous soils.

The aim of this study was to develop techniques to evaluate soil phosphorus (P) sorption capacity (PSC) and determine critical soil P levels to predict P loss potential for calcareous soils. Seventy-five soils mostly from Northern China were analyzed for soil P using four extraction methods (water, Pw; carbonate, POls; ammonium oxalate, Pox; and Mehlich 3, PM3) as well as PSC derived from single-point (PSC150) and multipoint sorption (S t) isotherms. Strong correlation was found between PSC150 and S t (r (2)=0.89, p<0.001). The sum of αCaM3 and ßMgM3 as an index of PSC (PSC(CaM3 + MgM3)) was most closely related to the maximum amount of P sorbed (S max) as given by the sum of S t and soil initial P setting α=0.039 and ß=0.462 (r (2)=0.80, p<0.001). The degree of P saturation (DPS) was thereafter calculated from PSC(CaM3 + MgM3) (DPS(CaM3 + MgM3)), to which Olsen P (POls) was significantly correlated (r (2)=0.82, p<0.001). In a split-line regression from Pw against DPS(CaM3 + MgM3) (r (2)=0.87, p<0.05), a change point was identified at 28.1% DPS(CaM3 + MgM3), which was equivalent to 49.2 mg kg(-1) POls and corresponded to a Pw concentration of 8.8 mg kg(-1). After the change point, a sharp increase in Pw was observed. Our results reveal a new approach to approximating DPS from CaM3 and MgM3 for calcareous soils without the need to generate a S max. We conclude that in the absence of an environmental soil test criteria for P, the DPS(CaM3 + MgM3) and POls could be used to predict P loss potential from calcareous soils.

Leaching of veterinary antibiotics in calcareous Chinese croplands.

Veterinary antibiotics reach the soil environment by manure application, where they accumulate or are prone to vertical translocation. We assumed that a high pH value at slightly calcareous soil properties should retain tetracyclines and fluoroquinolones even at high manure loads, whereas it should facilitate leaching of sulfonamides. Hence, we investigated the transport of manure-added antibiotics in a soil developed from calcareous parent material on a farm in peri-urban Beijing, China. Leachate was collected from zero-tension samplers, installed at 40cm depth under undisturbed soil, which was treated according to (i) routine farm practice and (ii) worst-case conditions (high antibiotic concentrations, irrigation imitating heavy rainfall). Additionally, the soil depth distribution of pharmaceuticals at the end of the leaching experiment was analysed. Under routine farm practice, sulfamethazine was repeatedly detected in the leachate with a maximum concentration of 0.12µgL(-1). All applied substances were still detected in soil after 53days, suggesting that there was no overall rapid and complete dissipation. Worst-case conditions enhanced vertical translocation; all leachate samples contained sulfonamides (up to 653µgL(-1) sulfamethazine), and even tetracyclines were found in the leachate once, with doxycycline reaching the highest concentration (0.19µgL(-1)). The concentrated simultaneous occurrence of sulfonamides with the bromide tracer in leachate samples pointed to preferential flow as underlying transport process. The high pH values did not prevent the single leaching event for tetracyclines and hardly affected overall leaching behaviour. The applied fluoroquinolones were not significantly translocated below 4cm depth, irrespective of irrigation and high manure addition.

Surface runoff and nitrogen (N) loss in a bamboo (Phyllostachys pubescens) forest under different fertilization regimes.

Nitrogen (N) losses from agricultural fields have been extensively studied. In contrast, surface runoff and N losses have rarely been considered for bamboo forests that are widespread in regions such as southern China. The thriving of bamboo industries has led to increasing fertilizer use in bamboo forests. In this study, we evaluated surface runoff and N losses in runoff following different fertilization treatments under field conditions in a bamboo (Phyllostachys pubescens) forest in the catchment of Lake Taihu in Jiangsu, China. Under three different fertilization regimes, i.e., control, site-specific nutrient management (SSNM), and farmer's fertilization practice (FFP), the water runoff rate amounted to 356, 361, and 342 m(3) ha(-1) and accounted for 1.91, 1.98, and 1.85% of the water input, respectively, from June 2009 to May 2010. The total N losses via surface runoff ranged from 1.2 to 1.8 kg ha(-1). Compared with FFP, the SSNM treatment reduced total nitrogen (TN) and dissolved nitrogen (DN) losses by 31 and 34%, respectively. The results also showed that variations in N losses depended mainly on runoff fluxes, not N concentrations. Runoff samples collected from all treatments throughout the year showed TN concentrations greater than 0.35 mg L(-1), with the mean TN concentration in the runoff from the FFP treatment reaching 8.97 mg L(-1). The loss of NO3(-)-N was greater than the loss of NH4(+)-N. The total loss of dissolved organic nitrogen (DON) reached 23-41% of the corresponding DN. Therefore, DON is likely the main N species in runoff from bamboo forests and should be emphasized in the assessment and management of N losses in bamboo forest.