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.

Programmable optically reconfigurable gate array architecture and its writer.

Recently, optically reconfigurable gate arrays (ORGAs), which consist of a gate array VLSI, a holographic memory, and a laser array, have been developed to achieve huge virtual gate counts that vastly surpass those of currently available VLSIs. By exploiting the large storage capacity of a holographic memory, VLSIs with more than 1 teragate counts will be producible. However, compared with current field programmable gate arrays, conventional ORGAs have one important shortcoming: they cannot be reprogrammed after fabrication. To reprogram ORGAs, a holographic memory must be disassembled from its ORGA package, then reprogrammed outside of the ORGA package using a holographic memory writer. It must then be implemented onto the ORGA package with high precision techniques beyond that which can be provided by manual assembly. Therefore, to improve this shortcoming, this paper proposes what is believed to be the world's first programmable ORGA architecture with no disassembly. Finally, the availability of this architecture is discussed based on the experimental results.

Targeted inactivation of synaptic HRG4 (UNC119) causes dysfunction in the distal photoreceptor and slow retinal degeneration, revealing a new function.

HRG4 (UNC119) is a photoreceptor protein predominantly localized to the photoreceptor synapses and to the inner segments to a lesser degree. A heterozygous truncation mutation in HRG4 was found in a patient with late onset cone-rod dystrophy, and a transgenic (TG) mouse expressing the identical mutant protein developed late onset retinal degeneration, confirming the pathogenic potential of HRG4. Recently, the dominant negative pathogenic mechanism in the TG model was shown to involve increased affinity of the truncated mutant HRG4 for its target, ARL2, which leads to a delayed decrease in its downstream target, mitochondrial ANT1, mitochondrial stress, synaptic degeneration, trans-synaptic degeneration, and whole photoreceptor degeneration by apoptosis. In this study, the mouse HRG4 (MRG4) gene was cloned and targeted to construct a knock-out (KO) mouse model of HRG4 in order to study the effects of completely inactivating this protein. The KO model was examined by genomic Southern blotting, Western blotting, immunofluorescence, funduscopy, LM and EM histopathology, ERG, and TUNEL analyses. The KO model developed a slowly progressive retinal degeneration, characterized by mottling in the fundus, mild thinning of the photoreceptor layer, and increase in apoptosis as early as 6 months, dramatic acceleration at approximately 17 months, and virtual obliteration of the photoreceptors by 20 months. When compared to retinal degeneration in the TG model, significant differences existed in the KO consisting of more severe and early photoreceptor death without evidence of early synaptic and trans-synaptic degeneration as seen in the TG, confirmed by LM and EM histopathology, ERG, and Western blotting of synaptic proteins. The results indicated a dysfunction in the KO outside the synapses in the distal end of photoreceptors where MRG4 is also localized. Differences in the phenotypes of retinal degeneration in the KO and TG models reflect a dysfunction in the two opposite ends of photoreceptors, i.e., the distal inner/outer segments and proximal synapses, respectively, indicating a second function of MRG4 in the distal photoreceptor and dual functionality of MRG4. Thus, inactivation of MRG4 by gene targeting resulted in a retinal degeneration phenotype quite different from that previously seen in the TG, attesting to the multiplicity of MRG4 function, in addition to the importance of this protein for normal retinal function. These models will be useful in elucidating the functions of HRG4/MRG4 and the mechanism of slow retinal degeneration.

Truncation mutation in HRG4 (UNC119) leads to mitochondrial ANT-1-mediated photoreceptor synaptic and retinal degeneration by apoptosis.

PURPOSE: To characterize the time course of apoptosis and degeneration in a transgenic mouse model of retinal degeneration based on truncated mutant HRG4; to investigate the nature of binding of the mutant HRG4 to its target, ADP-ribosylation factor-like (ARL)2; to study its effects on the downstream molecules Binder-of-ARL2 (BART) and adenine nucleotide transporter (ANT)-1 and on the induction of apoptosis. METHODS: Saturation binding, microscopic morphometric, Western blot, immunofluorescence, and TUNEL analyses were used. RESULTS: Increased apoptosis did not occur until 20 months in the transgenic retina, consistent with the delayed-onset degeneration in this model. The truncated HRG4 protein exhibited approximately threefold greater affinity for ARL2 than the wild-type HRG4, likely resulting in nonfunctional sequestration of ARL2. A significant decrease in ARL2 was present by 20 months, accompanied by a 50% decrease in ANT-1 in the photoreceptor synaptic mitochondria, with evidence of mitochondrial dysfunction. Preapoptotic degeneration in the photoreceptor synapse was demonstrated with cytochrome c release and caspase 3 activation within the synapse-without evidence of TUNEL-positive apoptosis in the photoreceptor cell body-indicating an initial event in the synapse leading to apoptosis. Caspase 3 was activated in the accompanying secondary neuron, consistent with transsynaptic degeneration. CONCLUSIONS: The results support a novel mechanism of retinal degeneration in which preapoptotic degeneration starts in the photoreceptor synapse because of a deficiency in ANT-1 and spreads to the secondary neuron transsynaptically, followed by apoptosis and degeneration in the cell body of the photoreceptor.

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.

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.

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.

Relationships among self-efficacy, communication, self-management skills and mental health of employees at a Japanese workplace.

We investigated relationships among self-efficacy, self-management skills, communication with superiors and mental health of employees at a Japanese workplace. The subjects were 426 employees in a medium-sized manufacturing company in Kyushu. In 1999, with agreement of the company, we mailed a self-administrated questionnaire which included questions on age, gender, job rank, communication with superiors, a General Self-Efficacy Scale(GSES), a Self-Management Skill scale(SMS) 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 55 percent. By multiple regression analysis, we found 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 age, job rank, communication with superiors and self-management skills would contribute to the mental health of Japanese employees.

[Development of the Japanese version of the Rathus Assertiveness Schedule].

The present study investigated the reliability and validity of the Japanese version of the Rathus Assertiveness Schedule (RAS) preparatory to study the relationship between self-expression skills and mental health status of employees at a Japanese worksite. Assertiveness is one of self-expression skills and defined as standing up for one's own rights as well as for others. RAS that the most widely used was developed by Rathus in the U.S.A. and consists of 30 items. We developed the Japanese version of RAS (J-RAS) along with a back-translation. The subjects were 173 participants of a 2-day assertiveness training course from July to December, 2001 and 364 workers in a manufacturing company in the Kyushu area. We sent the J-RAS to the 173 participants before they commenced the course, and of them 170 participants returned sufficient answers for analysis. During the course their trainers completed the objective evaluations on assertive self-expression. We compared their answers with the trainers' evaluations by the Pearson's correlation to certify the J-RAS's validity. We also mailed the J-RAS to the manufacturing workers in June, 2001. Of them, 266 workers returned sufficient answers by the end of the month. We calculated the Cronbach's alpha coefficient by them to certify the internal consistency reliability of the J-RAS. In August, 2001, we mailed the J-RAS again to 98 workers who agreed to retake the test. We studied the Pearson's correlation between the initial answers and the following ones to certify the test-retest reliability of the J-RAS, using the 98 answers of the workers who agreed to be retested. Our results found that 19 item sets, excluding Q3--7, 9, 13, 19, 20, 25, 28, had significantly positive correlation with the objective evaluations. The sum of the 19 items of the J-RAS (19-item J-RAS) had significantly higher correlations with the objective evaluation than that of 30 items of the J-RAS (30-item J-RAS). The internal consistency reliability of the 19-item or 30-item J-RAS was high, because their Cronbach's alpha coefficient was more than 0.80. Their test-retest reliability was also high, because the Pearson's correlation coefficient between the initial test and the subsequent test was more than 0.84 (ps < 0.001). Our results implied that the validity and reliability of the J-RAS was could be considered as acceptable and that the 19-item J-RAS measured the assertiveness of Japanese people more exactly than the 30-item J-RAS.

Photoreceptor synaptic protein HRG4 (UNC119) interacts with ARL2 via a putative conserved domain.

Human retinal gene 4 (HRG4) (UNC119) is a photoreceptor synaptic protein of unknown function, shown when mutated to cause retinal degeneration in a patient and in a confirmatory transgenic model. ADP-ribosylation factor-like protein 2 (ARL2) was identified as an interactor of HRG4 by the yeast two-hybrid strategy. The presence of ARL2 in the retina and co-localization with HRG4 was confirmed by Western blot and double immunofluorescence analysis, respectively. The interaction of ARL2 with HRG4 was further confirmed by co-immunoprecipitation and direct binding analysis. Phosphodiesterase delta (PDEdelta) is an ARL2-binding protein homologous to HRG4. Amino acid residues of PDEdelta involved in binding ARL2 and forming a hydrophobic pocket were shown to be highly conserved in HRG4, suggesting similarity in binding mechanism and function.

Changes in retinal synaptic proteins in the transgenic model expressing a mutant HRG4 (UNC119).

PURPOSE: HRG4 (UNC119) is a photoreceptor synaptic protein, a truncation mutant of which has been shown to cause late-onset cone-rod dystrophy in a patient and retinal degeneration with marked synaptic degeneration in a transgenic model. To investigate the mechanism of the retinal degeneration, the effect of the mutant protein expression on the other synaptic proteins was examined. METHODS: The status of 12 known synaptic proteins in the retinas of 5-month- and 13-month-old HRG4 transgenic and control mice was examined by Western blot analysis. Three selected proteins were analyzed by immunofluorescence in the 13-month-old retinas. The 12 proteins were tested for binding to HRG4 by a direct-binding assay and Western blot analysis. RESULTS: A decrease in three synaptic vesicle proteins and an increase in five cytoplasmic and plasma membrane proteins was detected by Western blot analysis in the older but not the younger transgenic retinas. These changes were demonstrated in both the outer and inner plexiform layers of the retina by immunofluorescence, along with a significant reduction in the thickness of the inner plexiform layer. A 23-kDa specie was found to bind to HRG4, but none of the 12 synaptic proteins matched it, according to immunoblot analysis. CONCLUSIONS: The expression of a mutant HRG4 protein in the photoreceptor synapses of the transgenic model had an intrasynaptic and transsynaptic effect, resulting in a decrease in three synaptic vesicle proteins, an increase in five cytoplasmic and plasma membrane proteins, and a significant reduction in the thickness of the inner plexiform layer. These changes were age dependent, similar to the pathologic phenotype of the transgenic model and the patient, and supported a close relationship of HRG4 with other participants in synaptic vesicle function. This interaction was not mediated by a direct coupling of HRG4 with any of the tested synaptic proteins but possibly through interaction with a 23-kDa protein.