Background: Studies have shown that poor sleep could result in many unpleasant consequences and is prevalent in nurses. Considering the fact of high stress, overwhelming workload and many night shifts in the emergency department in China, this study aimed to evaluate the current status of emergency nurses' sleep quality in public hospitals in Shandong, China and explored its influencing factors. Methods: A self-administered questionnaire incorporating the Job Content Questionnaire and Pittsburgh Sleep Quality Index (PSQI) was conducted among 4856 emergency nurses in five randomly selected city emergency command systems in Shandong, China. The association of potential influencing factors, including occupational, psychosocial and individual factors, with poor sleep (PSQI> 5) was quantified by multivariate logistic regression analysis. Results: The average PSQI score of 4730 emergency nurses in public hospitals was 8.2 ± 3.9, including 3114 (65.8%) subjects with PSQI > 5 and 2905 (61.4%) > 8; these figures were found highest for 337 emergency nurses in 14 tertiary hospitals with 11.8 ± 4.3, 257 (76.3%) and 232 (68.8%), followed by 1044 emergency nurses in 43 secondary hospitals with 9.5 ± 3.9, 725 (69.4%) and 675 (64.7%) and 3349 emergency nurses in 167 primary hospitals with 7.4 ± 3.5, 2132 (63.7%) and 1998 (59.7%). The following factors were associated with poor sleep: hospital level (tertiary vs. primary, secondary vs. primary), female sex, less of exercise, long work hours per week, many patients in the charge of at night, high monthly night shift frequency (4-6 vs. never, ≥7 vs. never) and high occupational stress. Conclusions: The sleep quality of emergency nurses in public hospitals in China was poor, especially in tertiary hospitals. Many factors as listed above, especially occupational stress, night shift taking and workload at night, should be considered when improving emergency nurses' sleep quality.

ObjectiveLow back pain (LBP) could cause serious consequences and has been shown to be prevalent among emergency ambulance workers. Studies on the prevalence of and risk factors for LBP among emergency ambulance workers are scarce in China. The study aimed to determine the prevalence of LBP among ambulance workers, including doctors, nurses and drivers, and to explore the risk factors for ambulance nurses’ chronic LBP (lasting for at least 3 months).DesignCross-sectional study.SettingEmergency ambulance systems from 38 tertiary hospitals in Shandong, China were selected by random cluster sampling.ParticipantsA total of 1560 ambulance workers completed the study.Outcome measuresA paper-based questionnaire that included the Nordic Musculoskeletal Questionnaire, which evaluated LBP, the Dutch Musculoskeletal Questionnaire, which assessed ergonomic factors, and the Job Content Questionnaire, which assessed stress, was used. Multivariate logistic regression analysis was conducted to quantify the association of potential risk factors with chronic LBP among ambulance nurses.ResultsThe 1 year prevalence of LBP lasting for at least 24 hours, 7 days and 3 months was 86.1%, 50.6% and 21.1%, respectively, among 498 ambulance nurses; 70.5%, 36.4% and 15.8% among 519 doctors; and 57.5%, 23.8% and 12.3% among 543 drivers. The factors contributing to chronic LBP among ambulance nurses were the frequent bending of the trunk, heavy or awkward lifting, shift work, low job satisfaction, high psychological fatigue, high psychological job demand, low job control, low supervisor support, older age, female sex and obesity.ConclusionsLBP was more prevalent among ambulance nurses than among ambulance doctors and drivers. Many factors, especially psychosocial and ergonomic factors, contributed to ambulance nurses’ chronic LBP. Comprehensive measures might be needed to control LBP.

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Background: Phytomedicines are proven to treat various chronic diseases as these compounds are cost-effective with few or no side effects. Elucidating the ameliorative effect of phytomedicine on cerebral ischemia may be a potent alternative therapy. Citronellol, a monoterpene alcohol, is one such phyto compound present in the essential oils of Cymbopogon nardus and Pelargonium geraniums and has immense pharmacological properties such as antihyperalgesic, anticonvulsant and antinociceptive. Objective: In the present work, the anti-ischemic effect of citronellol in both cellular and animal models of stroke was analyzed. Methods: Citronellol-pretreated SH-SY5Y cells were subjected to oxygen-glucose deprivation and reperfusion. The cells were assessed for cell viability and LDH quantification. Inflammatory cytokines were estimated in the cell lysate of citronellol pretreated OGD-R induced cells. Healthy young SD rats were pretreated with citronellol and induced with MCAO-R. The control group was comprised of sham-operated rats treated with saline. Group II was comprised of MCAO/R-induced untreated rats. Groups III and IV rats were previously treated with 10 mg/kg and 20 mg/kg citronellol, respectively, for 7 consecutive days and induced with MCAO/R. Brain edema was analyzed by quantifying the water content and the percentage of infarct was assessed using the TTC staining technique. Acetylcholinesterase activity and neurological scoring were performed to assess the neuroprotective activity of citronellol. Lipid peroxidation and antioxidant levels were quantified to evaluate the antioxidant activity of citronellol. The anti-inflammatory activity of citronellol was assessed by quantifying proinflammatory cytokines using commercially available ELISA kits. Results: Citronellol treatment significantly ameliorated neuronal damage in both cellular and animal stroke models. Prior treatment of citronellol significantly decreased the inflammatory cytokines and increased the antioxidants. Citronellol treatment effectively protected the rats from MCAO/R-induced brain edema. Conclusion: Our results confirm that citronellol is an effective anti-ischemic drug with antioxidant and anti-inflammatory properties.