Characteristics of health counselling in the workplace via e-mail.

This study was conducted to examine how health counselling via electronic mail (e-mail health counselling) was used in the workplace. The definition of health counselling employed in this study was 'any assistance to an individual seeking to solve any health problem'. A total of 2119 health counsellings conducted at a Japanese company's head office (700 employees) in 1997 and 1998 was used for the analysis, which compared four health counselling methods: e-mail, face-to-face, telephone and ordinary mail. This study distinguished four main characteristics of e-mail health counselling. First, the most and second most frequently used counselling methods were face-to-face and telephone counselling, at 70 and 15%, respectively, with e-mail health counselling ranked third at 13%. e-mail counselling was the second most frequently used method for employees in their 20s and 30s, while it ranked third among those over 40. Only 6% of employees in their 50s used e-mail counselling. Secondly, the proportion of mental health issues treated via e-mail counselling was significantly higher, at 26%, than for other counselling methods, which was at or below 10% for each of the other methods. Thirty-two per cent of all mental health counselling was conducted via e-mail. Thirdly, compared with face-to-face counselling, e-mail counselling dealt with more health issues related to primary prevention than with those related to secondary or tertiary prevention. Fourthly, compared with face-to-face counselling, e-mail counselling dealt more with health issues of third parties. These results suggest that e-mail health counselling may be useful in reaching people other than those targeted by the remaining counselling methods.

The number of steps taken by flight attendants during international long-haul flights.

BACKGROUND: Previous studies have revealed that female cabin attendants on long flights are most likely to have health problems. Since health problems can be related to workload and work stress and since the number of steps taken by an employee during a work shift can be an objective measure of the work load of cabin attendants, it is necessary to evaluate the predictors of the number of steps. METHODS: We used pedometers worn by 118 female flight attendants to study the number of steps during flights and its predictors during long international flights. RESULTS: The mean number of steps during 636.53 (SD = 129.11 )-minute flights was 10,742.85 (SD = 3,547.17). The crude number of steps per minute was 16.88, and the adjusted number of steps per minute was 14.04. Flight length and the number of sleeping hours worked (i.e., between midnight and 6:00 am) were significant predictors of the number of steps. CONCLUSION: Although it is implied that flight duration and night flight increase the work load of flight attendants, we need to consider psychological aspects to evaluate the overall effects of their jobs on work stress and health.

A signal detection approach to the combined effects of work stressors on alcohol consumption.

OBJECTIVE: To test the relationship between work stress and alcohol consumption and the efficacy of signal detection analysis in a work stress-alcohol consumption study. METHOD: The study was part of a Work Site Health Project, which included a stress reduction program, at a manufacturing company in Osaka, Japan. The study design was a cross-sectional survey. The participants were Japanese male whitecollar workers (N = 457; 30 to 50 years old) in the head administrative office of a large manufacturing company. Measurements consisted of demographic variables of the workers (age, marital status, manner of living and Type A personality), work stress measures, working hours and alcohol consumption. RESULTS: Of eight independent variables, six significant predictors of heavy alcohol consumption were identified in the first signal detection analysis. Of these six variables, job demand and skill discretion were work-stress-related measures. In the second multiple regression analysis, skill discretion and job demand were significant predictors of alcohol consumption among the workers in two of the seven subgroups categorized by the first signal detection analysis. CONCLUSIONS: It was revealed that work stress did relate to alcohol consumption. However, the effect of the work stress upon alcohol consumption was limited to specific types of workers with multiple specific attributes. It was also inferred that the signal detection approach is an effective approach to the work stress alcohol consumption relationship.

Work stressors, drinking with colleagues after work, and job satisfaction among white-collar workers in Japan.

Although previous studies have examined the buffering effects of social support and coping style on the relationship between stress and alcohol consumption, they have typically relied on analysis of variance (ANOVA) or regression analysis. In addition, few studies have examined the potential stress-buffering effects of drinking with coworkers after work on the relationship between job stress and job dissatisfaction. In the present study, using a signal detection analysis, we evaluated the interactions of drinking with coworkers after work and work-stressor variables among Japanese white-collar workers (n = 397) in 1997. The analysis was performed for two groups of subjects divided based on their status in the company. This was necessary because in Japan the obligations to drink socially increase with one's rising status in the company. In both the "staff members and lower-level managers" and "middle-level and higher-level managers' groups, an interaction between work-stressor variables and drinking variables was observed. The findings imply that drinking with coworkers after work ameliorated the sense of job dissatisfaction, but only among those subjects who already had lower levels of work stressors. For subjects with high levels of work stressors, attitudes toward drinking with coworkers were unrelated to job satisfaction levels.

Work stressors and alcohol consumption among white-collar workers: a signal detection approach.

OBJECTIVE: Previous findings regarding the relationship between work stress and alcohol consumption are inconsistent and inconclusive. One of the primary reasons for the inconsistency of the findings is that simple models, such as multiple regression analysis or analysis of variance (ANOVA), have been conventionally adopted in studies examining the relationship between work stressors and alcohol consumption. Since higher order interactions of multiple work stressors, which lead to heavy alcohol consumption, might not be fully uncovered within the framework of a multiple regression analysis or ANOVA, another approach to exploring the interactions of work stressors is presented in this study. METHOD: A signal detection analysis method was used to evaluate higher order interactions of work stress variables and to obtain basic information on 465 Japanese male white-collar workers. RESULTS: Of 11 work stressor or work position variables, four significant predictors of heavy alcohol consumption were identified. CONCLUSIONS: Two procedures were successfully performed in this study: (1) evaluating several higher order interactions of work stressors associated with heavy alcohol consumption, and (2) obtaining basic information to permit dividing the subjects into subgroups for further analysis using models and independent variables unique to each subgroup.

Surgical treatment for recurrent tumors of primary malignant melanoma of the esophagus: a case report and review of the literature.

The purpose of this communication is to present a case of resection performed for local recurrent tumors of primary malignant melanoma of the esophagus (PMME) and to review the relevant literature. The patient was a 54 year-old man who had received an intraabdominal esophagectomy with a total gastrectomy for primary malignant melanoma of the abdominal esophagus in another hospital, in November 1995. After the initial operation, he was treated as an outpatient. In August 1997, computed tomography and ultrasonography revealed recurrent tumors in the dorsal pancreatic lymph node and in the right adrenal gland. The recurrent tumor of the dorsal pancreas directly invaded the dorsal pancreas parenchyma and occluded the superior mesenteric vein and splenic vein, and the other metastatic tumor in the right adrenal gland existed in the absence of circumference invasion. Metastases of the PMME were confirmed in the dorsal pancreas, the superior mesenteric vein, splenic vein, and right adrenal gland, and were removed by a total pancreatectomy on October 7, 1997. By immunohistochemical staining, we found that the focal areas expressed S-100 protein and HMB-45 antibody. Currently (February 1998), the patient is alive and disease-free. PMME is an extremely rare tumor with a poor prognosis for survival. Only 2 cases of removal of recurrent tumors, including the present case, have been reported. The treatment of choice is surgical resection, even in cases of recurrence, because radiotherapy and/or chemotherapy have not been proven to be beneficial; however, they may play a palliative role if surgery is not possible.

CTLA4IgG treatment induces long-term acceptance of rat small bowel allografts.

BACKGROUND: CTLA4 immunoglobulin (Ig)G that binds to B7 effectively inhibits the signaling of CD28/CTLA4-B7 pathway and induces antigen specific T cell unresponsiveness in vitro and in vivo. Using CTLA4IgG, we examined induction of long-term graft survival and the mechanism of maintenance of tolerance in rat allogeneic small bowel transplantation. METHODS: Small bowels of Brown-Norway rats (RT1n) were heterotopically transplanted into Lewis rats (RT1l). Recipients were treated with an i.p. injection of either CTLA4IgG or control IgG for 7 days. RESULTS: Long-term survival was observed in rats treated with CTLA4IgG, whereas control rats died within 16 days after transplantation. To examine whether a tolerant state was established in long-term survival rats, secondary transplantation was performed using small bowels of Brown-Norway rats or ACI (RT1b) rats. It was demonstrated that small bowels of Brown-Norway rats were accepted; however, those of ACI rats were rejected within 10 days. Serum concentrations of interleukin (IL)-4 were maintained at >50 microg/ml for 7 days after transplantation in rats treated with CTLA4IgG but <15 microg/ml in control rats. IL-2 concentration was reduced to half in CTLA4IgG-treated rats compared with that in control recipients. Serum IFN-gamma in CTLA4IgG-treated recipients increased after transplantation and was not distinguishable from that of control recipients during the first 7 days after transplantation. Conclusion. We demonstrated that CTLA4IgG treatment alone for 7 days induced a long-term donor specific tolerance in rat allogeneic small bowel transplantation. The induction of long-term acceptance of small bowel allografts by CTLA4IgG is not caused by simply the shift of anti-alloimmune responses from Thl to Th2 cytokine production.

An inquiry into the causal relationship among leisure vacation, depression, and absence from work.

Depression is one of the most prevalent psychological health problems in occupational settings. Through literature review and the experience of previous investigations, it is now presumed that depression could mediate the association between workload and absence from work. In order to examine the above relationship, a follow-up investigation was conducted using male white-collar employees. The authors have been examining the association between work-related factors and employee health for some years, and vacation has become recognized as one of the important candidates for alleviating psychological problems in the workplace. In July 1996, the chance of leisure vacations within the past year and the presence of depression were examined by a self-administrated questionnaire. The subjects were followed-up for the rest of the year and absence from work was monitored. By analyzing 357 eligible subjects aged 20-59 years, the causal association between leisure vacation, depression, and absence from work was examined. Through correlation and log-linear analysis, the following findings were explored: The decrease of leisure vacation chances was correlated with the presence of depression, and depression contributed to an increase in the absence from work after adjustment was made for possible confounding factors. Leisure vacation could be independent of other work-related factors such as working hours, and it seemed to be significant to investigate positive effects of leisure vacation on psychological well-being in the workplace.

Quality of life domains in the healthy public: A trial investigation using attendants for an annual health checkup.

A trial investigation of subjects gathered for annual health checkups was performed to detect domains of quality of life in the healthy public, and to explore the changes of their demographic characteristics for the possibility of engaging them in health service activities in the community. The eligible 1,096 subjects aged 30-79 years were investigated. The period of this survey was from September to December, 1997. The subjects were questioned using ten quality of life domains which were preliminarily prepared and had been assumed to be most important in the subjects' lives in relation to the order of priority, importance, and satisfaction levels. The first most important domain in both the male and female subjects' lives was personal health, followed by relationships with family, though the mean importance scores for their personal health and relationships with family were almost equivalent. The mean scores for work abruptly decreased in males over 60 years of age. Also, the first large and the second relatively small principal components were extracted through principal components analysis. The proposed ten domains of quality of life are most likely valid and reliable in terms of the results analyzed and the comparison with a referred study. Relationships with family is an effective cue for health service activities in the community, and the significance of work on quality of life in the healthy public will have to be taken into account separately, especially in males.