Recovery of Percent Vital Capacity by Breathing Training in Patients With Panic Disorder and Impaired Diaphragmatic Breathing.

Slow diaphragmatic breathing is one of the therapeutic methods used in behavioral therapy for panic disorder. In practice, we have noticed that some of these patients could not perform diaphragmatic breathing and their percent vital capacity was initially reduced but could be recovered through breathing training. We conducted a comparative study with healthy controls to investigate the relationship between diaphragmatic breathing ability and percent vital capacity in patients with panic disorder. Our findings suggest that percent vital capacity in patients with impaired diaphragmatic breathing was significantly reduced compared with those with normal diaphragmatic breathing and that diaphragmatic breathing could be restored by breathing training. Percent vital capacity of the healthy controls was equivalent to that of the patients who had completed breathing training. This article provides preliminary findings regarding reduced vital capacity in relation to abnormal respiratory movements found in patients with panic disorder, potentially offering alternative perspectives for verifying the significance of breathing training for panic disorder.

Induction of the arginine vasopressin-enhanced green fluorescent protein fusion transgene in the rat locus coeruleus.

We examined the effects of intracerebroventricular (i.c.v.) administration of colchicine on the expression of the arginine vasopressin (AVP)-enhanced green fluorescent protein (eGFP) fusion gene in rats. In rats administered i.c.v. vehicle (control), eGFP fluorescence was observed in the supraoptic nucleus (SON), the magnocellular division of the paraventricular nucleus (PVN), the suprachiasmatic nucleus (SCN), the median eminence (ME) and the posterior pituitary. Two days after i.c.v. administration of colchicine, eGFP fluorescence was markedly increased in the SON, the magnocellular and parvocellular divisions of the PVN, the SCN, the ME and the locus coeruleus (LC). Immunohistochemical staining for eGFP confirmed the distribution of fluorescence in both groups. In the colchicines-administered groups, immunohistochemistry for tyrosine hydroxylase (TH) revealed that the eGFP fluorescence was co-localised with TH-immunoreactivity in the LC. Similarly, in situ hybridization histochemistry for eGFP mRNA revealed a significant increase in gene expression in the LC, the SON and the PVN 12-48 h after administration of colchicine. Our results indicate that the synthesis of AVP-eGFP is upregulated in noradrenergic neurones in the LC after colchicine administration. This implies that AVP and noradrenaline, originating from LC neurones, might play a role in response to chronic stress.

Effects of a mental health training program for manufacturing company managers.

We practiced interventional approaches for the promotion of occupational mental health in a manufacturing company with approximately 2,000 workers, between 2005 and 2007. We investigated the long-term effects of our mental health training program--including Active Listening (AL) training for managers--on perceived job stressors, stress reactions and social supports of workers, and mental sick leave. We conducted the mental health training program with AL training for all managers in order to improve their communication skills and support for workers. The investigation was conducted using the Brief Job Stress Questionnaire (BJSQ). In addition, we surveyed the number of workers taking sick leave due to mental problems from 2003 to 2007. Among the categories of "job stressors" in the BJSQ, the scores for "quantitative workload," "qualitative workload" and "physical demands" improved significantly after our interventional approaches. The number of workers taking sick leave had been increasing gradually from 2003 to 2005, but this decreased by approximately half in 2006 and 2007. Our mental health training programs for managers were successful in decreasing some job stressors, stress reactions, and workers' sick leave due to mental problems.

Urinary 8-hydroxydeoxyguanosine levels and psychological reactions after sleep deprivation.

The aim of this study was to investigate whether changes in urinary 8-hydroxydeoxyguanosine (8-OH-dG), an oxidative stress indicator, occur or not, and how psychological reactions change, after one night of sleep deprivation (SD) and after 7 hour recovery sleep opportunities during three recovery days. Twenty healthy subjects participated in this study. We measured their urinary 8-OH-dG levels and psychological reactions using the Profile of Mood States (POMS) for 5 days: on the baseline day, the post-vigil day, and on 3 recovery days after SD. The urinary 8-OH-dG levels and subscale scores of POMS were analyzed using repeated analysis of variance (ANOVA). In the psychological reactions, the values of Vigor on the post-vigil day and 2nd recovery day were significantly lower than on the baseline day. Fatigue and confusion on the post-vigil day were significantly higher than on the baseline day, and on the 1st and 2nd recovery days were relatively higher compared to the baseline day but returned to baseline level on the 3rd recovery day. The urinary 8-OH-dG levels did not change significantly after SD, on the post-vigil day or on the 3rd recovery days. These results suggest that the effect of one night of SD on psychological reactions continued for 2 or 3 days, and SD might not influence urinary 8-OH-dG levels despite marked changes in psychological reactions.

Recovery of cognitive performance and fatigue after one night of sleep deprivation.

OBJECTIVES: The aim of this study was to investigate how subjective sleepiness, mood states, simple and high-order cognitive performance change after one night of sleep deprivation (SD) and recover to after 7 h normal recovery sleep opportunity during three recovery days. METHODS: Ten healthy subjects participated in this study. We measured their subjective sleepiness, mood states and their performances of 2 simple tasks and 4 high-order cognitive tasks twice a day for 5 days, on the baseline day, post-vigil day and 3 recovery days after SD. This study was conducted considering each participant's motivation for task, learning effect and diurnal variation of performance. RESULTS: The performances of simple tasks such as addition or short-term memory were not reduced after SD and were the poorest on the baseline day, and improved gradually; however the high-order cognitive performances were at their lowest on the post-vigil day and needed 2 recovery sleep opportunities to return to the baseline level. Fatigue and confusion in mood states and subjective sleepiness were also at their lowest after SD. Subjective sleepiness nearly recovered to the baseline level on the 1st recovery day, but fatigue and confusion reached the baseline levels on the 2nd recovery day. CONCLUSION: These results suggest that cognitive deterioration and the recovery process may differ between simple task performance and high-order cognitive task performance, which needed 2 ordinary sleep opportunities to recover to the baseline level, and the change of subjective mood states were also different for each mood.

Development of a work improvement checklist for occupational mental health focused on requests from workers.

OBJECTIVES: To develop tools offering definite orientation for managers and employees to support their work improvement through occupational mental health. This research was a part of the Mental Health Improvement & Reinforcement Study (MIR study), conducted from October 2004 to March 2006. METHODS: We developed a trial version named the Kaizen Check List (KCL) by referring to problem solving methods for quality management. Then we improved it for a formal version named MIR Research of Recognition (MIRROR). A feedback form named MIR Action Guidance (MIRAGe) was also developed. We analyzed data from 1,953 respondents at five manufacturing enterprises in Japan using MIRROR and the Brief Job Stress Questionnaire (BJSQ) to determine whether or not the workers requesting work improvement had more stress than other workers. RESULTS: The KCL had 47 items, which indicated desirable working conditions for mental health at work, and four answer categories. MIRROR has 45 selected items and improved answer categories. MIRAGe displays the results of MIRROR and step-by-step guidance for work improvement. Respondents with request had significantly higher scores in stressor and lower scores in buffer factors compared with respondents without request in many items of MIRROR. CONCLUSIONS: A combinational use of MIRROR and stress scales is useful for finding worksites with high risk factors for mental health and for directing focus on work improvement at these worksites according to workers' requests.

[Effectiveness of mental health training including active listening for managers].

We carried out mental health training with Active Listening for managers of A company, which was the electronics manufacturing company with 1,900 employees. The purpose of the present study was to examine the effect on managers and employees in the workplace on the training. The subjects were all persons who managed regular employees directly in A company. We performed the investigation from May 2006 to February 2007 and carried out the training from September to November in 2006. The contents of the training were from the chapter on "The education and training of managers" in the "The guideline for maintenance and promotion of mental health for workers" issued by the Ministry of Health, Labour and Welfare in Japan in 2006. We divided the contents and implemented them in two sessions. "Responding to worker consultation" was one of the contents of Active Listening. In the first session, we explained about Active Listening, and in the second session we ran a practical involving Inventive Experiential Listening. One month later, we distributed material summarizing the training to all the participants. To evaluate the effect of the training, we conducted surveys of the participants using the Active Listening Attitude Scale (ALAS), prior to and after the training, and distributed questionnaires, post-training about the contents of the training and changes of consciousness and action. Furthermore, we performed surveys pre- and post-training using the Brief Job Stress Questionnaire (BJSQ) 12 items version, distributed to all employees. We evaluated the effect of the training on 124 managers and 908 workers by the investigation. The score of each subscale was analyzed by repeated measures analysis of variance. There were no significant differences in the scores of both the "Listening attitude" and "Listening skill" subscales of ALAS between pre-training and post-training, but the mean scores post-training were higher than those pre-training on both subscales. There were significant increases post-training in "Job demands", "Worksite support by supervisor" and "Worksite support by co-worker", subscales of the BJSQ 12 items version. Particularly, the "Worksite support by supervisor" subscale increased significantly in 8 of the 47 sections in a comparison among sections. In this present study, we investigated the effectiveness of mental health training including Active Listening for managers, and suggest that to train Active Listening and use it at the worksite possibly strengthens "Worksite support by supervisor".

Relationship between turnover and periodic health check-up data among Japanese hospital nurses: a three-year follow-up study.

The present study explored the relationship between turnover and periodic health check-up data among Japanese hospital nurses. The subjects were 379 registered nurses in a Japanese hospital and the duration of our study period was three years. By the proportional hazard model, we investigated the relative risks (RRs) of the turnover rate associated with the following: lifestyles (irregularity of meals, taking breakfast), work environment (working hours, work schedule), and health status (body mass index [BMI], serum total cholesterol [T-cho], taking medication, sleep disturbance). We obtained the data on turnover from October, 1997 to September, 2000. During the observed period we were able to follow up on 363 female nurses (96%) and the turnover total amongst them was 100. We divided the subjects into a younger (21-25-yr-old) and an older (>25-yr-old) group because of the interaction between age and turnover. In the younger group, we found that sleep disturbance influenced turnover significantly. On the other hand, in the older nurses, BMI and T-cho contributed to turnover significantly. Our results imply the possibility of a partial association between turnover and periodic health check-up data among the nurses.

Applying a solution-focused approach to support a worker who is under stress.

The solution-focused approach (SFA) developed by Insoo Kim Berg and Steve de Shazer at the Brief Family Therapy Center, Milwaukee, USA is classified as brief psychotherapy. We believe that SFA can give an occupational healthcare staff useful tools that will positively influence their relationships with workers, because it focuses on workers' strengths rather than their weaknesses when the staff interviews them using SFA. In this report, we explain the case of a worker who was under stress and was interviewed using SFA. Although the worker came to the interview because of his physical symptoms, he disclosed that he was under considerable stress at work and that his main concern was his relationship with his superior. One of the authors interviewed him using SFA. In the interview the worker discovered his own resources and strengths, and finally defined his goal. In the end, he discovered solutions by himself, and has been doing well in follow-up. We describe this process in detail, and discuss potential applications of SFA in occupational medicine.

Relationship between job stress and self-rated health among Japanese full-time occupational physicians.

OBJECTIVE: We investigated relationship between job stress and self-rated health among Japanese nese full-time occupational physicians (OPs). METHODS: In 2000, we mailed self-administrated questionnaires to 716 OPs. Of these OPs, 349 (49%) returned sufficiently completed questionnaires for analyses. oblique-rotated principal factor analysis of the job stress questionnaire extracted three components; low understanding of occupational health services in companies (low understanding), conflicts between occupational physicians and their coworkers (conflicts), and discrepancies between occupational physicians' routine work and occupational health services (discrepancies). RESULTS: The model, in which low understanding contributed to self-rated health through job satisfaction and self-rated health was influenced by job satisfaction and discrepancies, provided a good fit to the data. CONCLUSIONS: We found that a potential relationship between job stress and self-rated health among Japanese full-time OPs. The present results implied that among full-time OPs, low understanding contributed negatively to self-rated health through job satisfaction, and that self-rated health was influenced positively by job satisfaction and negatively by discrepancies.

Relationship between an interview-based health promotion program and cardiovascular risk factors at Japanese companies.

The present study investigated the relationship between an interview-based health promotion program and cardiovascular risk factors at manufacturing companies. Excluding insufficient data and the workers who took medication prescribed by a physician in 1993, the subjects were six hundred and twenty-nine 18-55-yr-old employees who had been working at two manufacturing companies in Kyushu from 1993 to 1997. The intervention company introduced an interview-based health promotion program from 1993. The program consisted of health measuring, group education, and health interviewing all employees to help with their behavioral change. We subdivided the subjects into younger (18-34-yr-old) and older (35-55-yr-old) groups. We defined changing degree (Delta) with (the following data in 1997) minus (the initial data in 1993). With agreement of the subject companies, we compared the Delta of each item, including body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), serum total cholesterol (T-cho), serum aspartate aminotransaminase (AST), serum alanine aminotransferase (ALT), and serum gammaglutamyl transpeptidase (GGTP), in the intervention with that in the reference. BMI and SBP decreased significantly after the program in the under 35-yr-old intervention group. On the other hand, T-cho, AST, ALT, and GGTP decreased and HDL increased significantly after the program in the over 34-yr-old intervention group. Our results showed that the worksite health promotion had the potential to improve cardiovascular risk factors of Japanese employees.

A study of the effects of active listening on listening attitudes of middle managers.

The present study was conducted to clarify the direct effects of active listening (AL) training given to middle managers in a local government. Altogether, 345 middle managers participated in 13 AL training sessions over two years. We developed the Inventive Experiential Learning (IEL) method, and used it as the central training method in this study. To investigate how well the participants learned AL, we asked the middle managers to answer a shorter version of the Active Listening Attitude Scale (ALAS) consisting of two subscales-i.e. "Listening Attitude" and "Listening Skill"-before training, one month after and three months after training. Altogether, 284 middle managers answered the questionnaire three times. The scores of each subscale were analyzed by repeated measurement analysis of variance. The participants were divided into three groups using the percentile values of the original sample of ALAS, i.e. low-score group (-24%), medium-score group (25-75%) and high-score group (76%-), and the proportionate changes were examined. The results showed both the "Listening Attitude" and "Listening Skill" subscales increased significantly after training. Analysis of the percentiles showed that the proportion of the low-score group decreased and that of the high-score group increased in both subscales, from one to three months after training. These changes are considered to indicate that the participants have learned AL although they attended AL training for only one day.

Diazepam attenuates conditioned histamine release in guinea pigs.

To clarify the possibility of pharmacological mediation on classical conditioning-associated asthmatic response, the effect of diazepam on an odor-induced conditioned histamine release was investigated in ovalbumin (OA)-sensitized guinea pigs, i.e. a model of bronchial asthma. The animals received conditioning sessions in which an antigen (OA) as the unconditioned stimulus and an odor (dimethylsulfide) as the conditioned stimulus (CS) were simultaneously inhaled. After the animals were intraperitoneally injected with saline or diazepam (2.5 or 5 mg/kg), they underwent exposure to the CS and blood collecting. This procedure was repeated three times in order that the animals would have each kind of injection. The animals injected with saline showed significantly higher levels of plasma histamine following the exposure to the CS as a conditioning effect compared with the baselines (P<0.05), whereas the group injected with diazepam (5 mg/kg) did not indicate such elevations. The suppressing effect of diazepam on the conditioned histamine release was also confirmed by a multiple regression analysis (5 mg/kg) and an analysis of covariance (2.5 and 5 mg/kg), even after adjustments for several factors regarding immunological sensitization and conditionability. The present study suggests that diazepam attenuates a conditioned histamine release.

Relationship between self-reported low productivity and overtime working.

OBJECTIVE: To investigate the relationship between overtime working and self-reported low productivity due to poor health over the course of 1 year. METHODS: The subjects were 94 random-sampled workers at a Japanese manufacturing company. The data on sickness absence and low productivity due to poor health were collected by self-report questionnaires every month from October 1999 to September 2000. Seventy-four workers returned complete answers. The complete data on overtime hours of forty-nine of these employees were obtained from company records. RESULTS: In those reporting low productivity, cold-like symptoms and sleep loss were given as the causes. Low productivity was closely linked to overtime worked, whereas sick leave tended to increase during periods of change in overtime working. CONCLUSION: Our results suggest the possibility of a relationship between overtime working and self-reported low productivity.

Relationship between burnout and communication skill training among Japanese hospital nurses: a pilot study.

We investigated the relationship between burnout and communication skill training among Japanese hospital nurses to improve the mental health of human service workers. The subjects were forty-five registered nurses referred to a self-expression skill intervention program by their section superiors, with each superior choosing from two to five nurses. The hospital was located in the Kyushu area and staffed by about four hundred nurses. The subjects were divided into an intervention group (19 nurses) and a reference group (26 nurses). The intervention group received the communication skill training in July and August, 2001. The communication skill training was carried out in accordance with the assertiveness training (AsT) precepts of Anne Dickson. In June, 2001, we delivered a set of questionnaires including age, gender, working years, a burnout scale, and a communication skill check-list as a baseline survey. The baseline questionnaires were returned at the end of June, 2001. In January, 2002, we delivered the same questionnaire again to the two groups and collected them at the end of the month. Excluding the only male and insufficient answers, twenty-six nurses (58%) returned complete answers in the initial and subsequent surveys. We found that the personal accomplishment and the two communication skills such as "accepting valid criticisms" and "negotiation" of the intervention group had improved significantly five months after the training as compared with that of the reference. Our results implied that communication skill training might have a favorable effect on burnout among Japanese hospital nurses.

Relationships among self-management skills, communication with superiors, and mental health of employees in a Japanese worksite.

The present study investigated relationships among self-management skills, communication with superiors, and the mental health of employees in a Japanese worksite. The subjects were manufacturing workers in a medium-sized company in Kyushu. In 1999, we mailed a self-administrated questionnaire which included questions on age, gender, job rank, communication with superiors, a General Self-Efficacy Scale, a Self-Management Skill Scale, and the Japanese version of the 12-item General Health Questionnaire (GHQ-12). Eighty percent of the subjects returned the questionnaire. Excluding senior managers and insufficient answers, the final response rate was fifty-five percent. The multiple regression analysis showed that job rank contributed significantly and positively and that age, communication with superiors, and self-management skills contributed significantly and negatively to the GHQ-12. Our results implied that self-management skills might have the potential of affecting the mental health of Japanese employees.