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Background: In times of disaster, public servants face multiple burdens as they engage in a demanding and stressful disaster-response work while managing their own needs caused by the disaster. Purpose: We investigated the effects of work-related factors on the mental health of prefectural public servants working in the area devastated by the Great East Japan Earthquake to identify some ideas for organizational work modifications to protect their mental health. Methods: Two months after the earthquake, Miyagi prefecture conducted a self-administered health survey of prefectural public servants and obtained 4,331 (82.8 %) valid responses. We investigated relationships between mental health distress (defined as K6 ≥ 13) and work-related variables (i.e., job type, overwork, and working environment) stratified by level of earthquake damage experienced. Results: The proportion of participants with mental health distress was 3.0 % in the group that experienced less damage and 5.9 % in the group that experienced severe damage. In the group that experienced less damage, working >100 h of overtime per month (adjusted odds ratio [OR], 2.06; 95 % confidence interval [CI], 1.11-3.82) and poor workplace communication (adjusted OR, 10.96; 95 % CI, 6.63-18.09) increased the risk of mental health distress. In the group that experienced severe damage, handling residents' complaints (adjusted OR, 4.79; 95 % CI, 1.55-14.82) and poor workplace communication (adjusted OR, 9.14; 95 % CI, 3.34-24.97) increased the risk, whereas involvement in disaster-related work (adjusted OR, 0.39; 95 % CI, 0.18-0.86) decreased the risk. Conclusions: Workers who have experienced less disaster-related damage might benefit from working fewer overtime hours, and those who have experienced severe damage might benefit from avoiding contact with residents and engaging in disaster-related work. Facilitating workplace communication appeared important for both groups of workers. [ABSTRACT FROM AUTHOR]

Background: Narcolepsy (NA) is a sleep disorder characterized by excessive daytime sleepiness and an increased propensity of rapid eye movement sleep. If left untreated, NA can lead to academic underachievement or job loss because of dozing off or mistakes caused by inattentiveness due to sleepiness. Purpose: Although untreated narcolepsy patients may suffer from many social disadvantages due to excessive daytime sleepiness, mostly it takes a long time to receive a definitive diagnosis of the disorder. This retrospective study investigated factors related to the period until definitive diagnosis among patients with narcolepsy in Japan. Methods: We enrolled 181 consecutive patients (108 men, 73 women; mean age 37.6 ± 16.6 years old; narcolepsy with cataplexy/narcolepsy without cataplexy = 131:50). Multivariate logistic regression analysis was performed with period until definitive diagnosis as the dependent variable and descriptive clinical variables as the independent variables. Results: The mean period until receiving the diagnosis among the participants was 9.9 ± 10.1 years. More than half of the patients first learned about the disorder from information provided by the media. Multivariate logistic analysis indicated that adult onset ( p < 0.01), onset in 1995 or later ( p < 0.001), and first learning about the disorder from a sleep disorder specialist physician or a general practitioner ( p < 0.001) were associated with a time taken for receiving a definitive diagnosis less than or equal to the median value (7 years). Conclusion: Improving access to information about the concept of the disorder and the medical institutions specialized in sleep disorders, especially via the Internet, would be necessary to promote early diagnosis of the disorder. [ABSTRACT FROM AUTHOR]

Background: Perceived stress and coping strategies may influence the risk of cardiovascular disease through their possible association with inflammation, but data remain controversial for perceived stress or scanty for coping strategies. Purpose: We examined the associations of perceived stress and coping strategies with serum high-sensitivity C-reactive protein (CRP) in a Japanese general population. Methods: This cross-sectional study included 2,971 men and 4,902 women aged 40-69 years who were enrolled between 2005 and 2007. Subjects with possible inflammation-related disease, CRP levels ≥3,000 ng/mL, or currently used analgesics or lipid-lowering drugs were excluded. Analyses were performed by gender with adjustment for lifestyle, socioeconomic, and psychosocial factors. Results: Unexpectedly, elevated perceived stress was significantly associated with lower CRP levels in men ( P < 0.001) but not in women ( P = 0.90) after adjustment for age and covariates. Among five items of coping strategies evaluated, 'disengagement' showed a significant inverse association with CRP in men only ( P = 0.027). In addition, a possible interaction between 'emotional support seeking' and perceived stress on CRP was detected in men ( P = 0.021); 'emotional support seeking' was associated with lower CRP at the high stress level only ( P = 0.028). Conclusions: Both perceived stress and coping strategies may be associated with systemic inflammation in Japanese men, yet caution must be exercised before accepting the stress-inflammation-disease pathway. [ABSTRACT FROM AUTHOR]

Background: Individuals with irritable bowel syndrome (IBS) have high anxiety. There is insufficient information about the relationships between concrete cognitive contents and anxiety in IBS. Purpose: The present study investigated the relationship between cognitive factors and anxiety in individuals with IBS. Method: The participants were 1,087 college students (male, 506; female, 576; unidentified, 5; age, 19.72 ± 1.76 years) who completed a set of questionnaires that included the Rome II Modular Questionnaire (based on diagnostic criteria for IBS), Anxiety Sensitivity Index (ASI), Cognitive Appraisal Rating Scale (CARS; subscales: commitment, appraisal of effect, appraisal of threat, and controllability) for measuring symptom-related cognition, an item about attention to abdominal symptoms, the Hospital Anxiety and Depression Scale-Anxiety Scale (HADS-A), and an item regarding the presence of avoidant behavior due to anxiety of IBS symptoms. Results: The participants included 881 individuals without IBS and 206 individuals with IBS. Individuals with IBS had higher ASI and HADS-A scores than those of the individuals belonging to the control group ( p < 0.001). Subscale scores of CARS (except those of controllability and attention to IBS symptoms) significantly correlated with the ASI and HADS-A scores ( p < 0.01). Individuals with IBS and avoidant behavior had higher subscale scores of CARS (except those of controllability and attention to IBS symptoms) and higher HADS-A scores ( p < 0.05). The hypothetical models containing ASI scores, subscale scores of CARS (except those of controllability), and HADS-A scores with and without attention to IBS symptoms exhibited a good fit. Conclusion: Severe anxiety sensitivity in individuals with IBS related to their symptom-related cognition, and the altered cognition increases anxiety, leading to the possible development of a disabling condition. [ABSTRACT FROM AUTHOR]

Background: Appropriate sensitivity threshold of accelerometer to measure total sleep time during nap is not established. Purpose: Actigraphy-derived total sleep times during naps were calculated using three different sensitivity threshold values and compared with polysomnography. Method: The mean age of the 60 subjects (53 men and 7 women) was 22.8, ranging from 22 to 27 years. Determination of the sleep stage by the polygraph and the sleep/wake judgment by the accelerometer obeyed the sleep/wake judgment, and the accelerometer was monitored under different sensitivity threshold settings. The study was carried out during one afternoon with a 3-h nap opportunity. Kappa statistics, correlations, and several indices of accuracy were compared using statistical methods. Results: The mean total sleep times during a nap set for 180 min were 160.4, 151.8, and 140.5 min, respectively, as judged under the low-sensitive, middle-sensitive, high-sensitive settings of an accelerometer worn on the non-dominant wrist. The corresponding mean total sleep time as calculated using a sleep polygraph was 133.0 min. Sleep/wake judgment by three levels of threshold values for the accelerometer showed that high-sensitive threshold showed relatively high specificity (0.452) compared with specificities by the low-sensitive threshold (0.249) or by the middle-sensitive threshold (0.358). The concordance correlation coefficients and 95% confidence intervals (in parenthesis) between the total sleep time judged by polygraph and low-sensitive, middle-sensitive, or high-sensitive accelerometer were 0.40 (0.26-0.51), 0.53 (0.38-0.65), and 0.64 (0.49-0.75), respectively. The Bland-Altman plot of the measurements showed higher agreement between the total sleep time by polygraph and by the accelerometer using the high-sensitive threshold. Conclusions: From the result obtained in this study, the high-sensitive accelerometer showed the strongest agreement of total sleep time and sleep/wake judgment with the calculated value using the sleep polygraph. [ABSTRACT FROM AUTHOR]