Breast Cancer Screening Behavior among Working Women in Japan: Characteristics and Factors Inhibiting Screening.

Background: Improving breast cancer screening rates is crucial for early detection. However, factors hindering regular screening among working women remain unclear. This study aimed to clarify screening behavior among working women in Japan and associated discouraging factors. Methods: Surveys were conducted from April to May 2019 among women aged 40-60 at public offices and companies in Tottori Prefecture. We used two surveys: the "Basic Attributes Questionnaire" and the "Structural Questionnaire on Rejecting Screening." Data analysis involved chi-squared tests, logistic regression analysis, factor analysis, and nonparametric tests. Results: Completed questionnaires analyzed were 668 out of 825 collected (response rate: 81.0%). Most participants were part-time employees with an average age of 51 years. Over 60% reported undergoing regular screening. Logistic regression analysis identified part-time employment, lack of children, a discouraging workplace atmosphere, and absence of personal connections to breast cancer patients as factors associated with avoiding breast cancer screening. Factor analysis identified five factors and 16 items as reasons for not undergoing regular screening. Women who had no spouse, no children or felt that their workplace was not encouraging breast screening felt difficulty in scheduling screening most strongly. Conclusion: Individuals who had part-time employment and had no children, did not know a breast cancer patient, or considered that their workplace environment was not supportive were more likely to avoid undergoing regular breast cancer screening. Also, women who did not undergo regular screening experienced difficulty in scheduling. In the future, the challenge lies in disseminating accurate knowledge about breast cancer to foster awareness without excessive anxiety.

Relationship Between Clinical Nursing Competence and Work Environment by Career Stage for Nurses with 1-10 Years of Clinical Experience.

Background: Clinical nursing competence includes ethics, cooperation with other professionals, and management, in addition to nursing abilities and responding per situation. Therefore, it may vary depending on one's experience and the work environment. However, there is a lack of studies exploring the competence for different experience levels. Therefore, this study aimed to clarify the association between clinical nursing competence and the work environment by experience groups. Methods: Anonymous self-administered questionnaire surveys were conducted on 717 nurses in regional core hospitals from December 2017 to March 2018. Clinical nursing competence was measured using the Clinical Nursing Competence Self-Assessment Scale (CNCSS). Association of CNCSS with experience and work environment was examined. Results: Responses from 231 nurses with 1-10 years of experience were analyzed. Compared with those in the 2-year experience group, those in the 3-5- and 6-10-year experience groups assessed their "planned development of nursing care" and "assessment of care" competencies to be higher. Additionally, compared with those in the 2-year experience group, those in the 6-10-year experience group assessed their "clinical judgment" and "care coordination" competencies to be higher. Nurses with 1 year of experience showed significant positive correlations between clinical nursing competence and "good interpersonal relationship," "clarity about the organization's vision," and "ease of taking time off"; and those with 6-10 years of experience showed significant positive correlations between clinical nursing competence and "support from superiors and senior coworkers" and "established and easily accessible support system for taking time off for childcare and caregiving." Conclusion: The relationship between clinical nursing competence and the work environment differed according to years of experience. Interventions to improve clinical nursing competence should be developed for each experience group considering the associations.

Examining the reliability and validity of a self-regulated learning strategy scale for undergraduate nursing students and effective factors of self-regulated learning strategies.

BACKGROUND: Self-regulated learning in higher education has increasingly attracted attention in recent years. This study involved a survey of nursing students using an originally developed tool called the Self-regulated Learning Strategy Scale for Undergraduate Nursing Students (SRLSS-NS). OBJECTIVES: We aimed to elucidate factors relating to the promotion of self-regulated learning while confirming the reliability and validity of the novel scale. DESIGN: A cross-sectional survey design was adopted. SETTING: School of Health Science, Faculty of Medicine. PARTICIPANTS: Participants included first- to fourth-year undergraduate nursing students. METHODS: Descriptive statistics were used to ascertain participant characteristics. We confirmed the criterion-related validity of the survey through exploratory factor analysis and Pearson's product-moment coefficient with external criteria. Reliability was calculated using Cronbach's α coefficient. To examine stability, we confirmed the correlation between the first and second surveys. Multiple regression analysis was performed using the SRLSS-NS score as the objective variable and basic attributes/individual factors, learning-related factors, and cognitive factors as explanatory variables. The statistical significance level was defined as 5 %. RESULTS: The scale consisted of 12 items related to three factors-construct validity, internal consistency, and stability-which were confirmed. Regarding factors related to the SRLS of undergraduate nursing students, the SRLSS-NS score was greater for items such as, "I feel that university education gives me confidence in learning" (ß = 0.255, p < 0.001), "I like/find interest in things I am learning" (ß = 0.228, p < 0.001), "I feel that university education teaches me how to learn" (ß = 0.198, p = 0.003), and "Self-esteem as a professional" (ß = 0.143, p = 0.023). CONCLUSION: As more efforts are made to improve undergraduate nursing students' SRLS, the importance of education for increasing confidence, promoting intrinsic motivation, teaching learning methods, and fostering occupational identity is emphasized.

Increased knowledge levels of patients with diabetes in resource-limited communities after receiving peer-led education.

Diabetes self-management education through peer support has been beneficial, especially in regions with limited medical resources. Studying the effects of education offered by trained peers of patients will facilitate tailoring the peer-led education programs to the regions' specific needs. Here, we evaluated changes in diabetes-related indicators in Filipino patients who received a peer-led education. We used data on 23 patients (age, 67.83 ± 6.69 years; 82.6% female) who participated in all five surveys performed every 6 months from March 2017 to March 2019. After the second survey until the end of this study, the participants were educated in diabetes self-management by their 13 peers who previously had received the training in diabetes self-management. Participants' knowledge of diabetes and the related 'cause, risk factors, nature of diabetes and complications' subindicator were greater on all surveys after starting the peer-led education compared with those on the second survey (i.e. before starting the education); these values did not differ between the first two surveys. Because increasing patients' knowledge can enhance their ability to self-manage their disease and thus improve their quality of life, strategies to expand patients' knowledge about diabetes should be included when organizing peer-led education in regions with limited medical resources.

Career stage-specific predictors of reflective ability among clinical nurses.

AIMS: To identify career stage-specific factors that influence reflective ability in clinical nurses and the relative strength of these effects. DESIGN: Exploratory cross-sectional study. METHODS: Between August and September 2019, nursing professionals working at general hospitals (n = 1169) completed a questionnaire on reflective ability and its suspected influencing factors. Participants were grouped by career stage as defined by years of nursing experience. Each factor's predictive strength regarding different dimensions of reflective ability was analysed separately in each group via stepwise multiple regression. RESULTS: Reflective ability was significantly influenced by support for personal growth from superiors and seniors among first-year participants and professional identity formation among those in their second or later years. Furthermore, it was significantly influenced by self-confidence in nursing practice in years 4-5, effort to improve knowledge and skills in years 6-9 and role model presence in years 10-19. CONCLUSION: Career stage-specific predictors of reflective ability were related to nurses' environment and changes in the roles expected of them. Support measures aimed at improving this capacity should emphasize factors characteristic of the career stage(s) of nursing professionals. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: Identifying the influencing factors of nurses' reflective ability can improve the same, deepen nurses' views on nursing, help them develop an intentional nursing practice and contribute to the improvement of the quality of nursing practice. IMPACT: This study is the first to identify career stage-specific predictors of reflective ability in clinical nurses and the relative strength of their effects. Reflective ability was affected by growth support from superiors and seniors in first-year nurses and formation of nursing identity in second-year nurses. Additionally, nurses' environment and various roles affected their reflective ability. Hospitals should build an appropriate environment for nurses and develop the concept of 'oneself as a nurse' among nurses. PATIENT OR PUBLIC CONTRIBUTION: This study was conducted with the approval of an ethical review committee that included general citizens. Furthermore, the research results were reviewed by general citizens prior to dissemination, and we received their opinions as to whether the writing was sufficiently clear and whether the information required by the audience was included. We improved the content to be disseminated based on relevant opinions provided.

Cognitive and Emotional Changes in Peer Educators of Type 2 Diabetes Patients After Starting Peer-Support Activities.

Background: Diabetes self-management education through peer support has beneficial effects, especially in regions with limited medical resources. To ensure peer educators continue to provide peer-led education programs, it is important that they remain motivated to instruct patients. Here, to explore measures to enhance peer-educators' motivation toward such programs, we examined the cognitive and emotional changes in Filipino type 2 diabetics after 7-month activities as peer educators. Methods: We individually performed semi-structured interviews with 13 peer educators with 20 years of age or above in August 2017 (immediately before starting their peer-education activities) and in March 2018 (7 months after the start). The first interview was performed after the peer educators had received 2-day training of diabetes self-management. In both interviews, we asked the peer educators about their feelings toward peer-led educational activities (e.g., satisfaction, difficulty, reward, confidence, and challenges). Their replies about their own cognition and emotions were interpreted and integrated, and then analyzed qualitatively. Results: Four and seven categories were extracted from the first and second interviews, respectively. The category "Cognition of patients' active learning attitudes and of positive changes in patients' physical conditions and behavior" observed in the second interview led to "Cognition of growth as a peer educator" and "Satisfaction with supporting patients as a peer educator." These two feelings gave the peer educators' "Increased motivation to continue the activities as a peer educator." This motivation was also associated with "Active collaboration among peer educators," which was affected by "Difficulties and concerns in working as a peer educator." Conclusion: To sustain diabetic peer-led education programs, we suggest that interventions be implemented that increase peer educators' motivation toward their activities and stimulate their awareness of the importance of collaborating with one another. Such collaboration should help to overcome the difficulties they may face in providing peer-led education.

Physical Function and Low Back Pain in Leek Farmers: A Comparison with Non-Farmers.

Background: The purpose of this study was to investigate the low back pain (LBP) and physical function of young to middle aged farmers of leeks in western Tottori Prefecture. Methods: Fifteen farmers (55 years old or younger) cultivating leeks in western Tottori Prefecture were recruited as the subjects, and 14 non-farmers matching the age and sex of the subjects were recruited as the control group. A questionnaire survey was conducted to determine the presence or absence of LBP, smoking, and alcohol consumption. Physical functions were measured by anthropometry (body fat percentage and muscle mass), Finger-Floor distance (FFD), back muscle strength, and upper body bending, and lumbar muscle cross-sectional area (CSA) was evaluated by magnetic resonance imaging (MRI). Results: Weight, BMI, body fat percentage, upper body bending, back muscle strength, and L3/4 iliocostalis lumborum CSA, current LBP were significantly higher in the leek farmer group. One-way analysis of variance showed significant differences in upper body bending, and history of LBP. Conclusion: LBP was more common among leek farmers. The characteristics of leek farmers with LBP were history of LBP.

Development of a Reflective Ability Scale for Clinical Nurses.

BACKGROUND: Enhancement of reflective ability leads to improved nursing practice and individual growth. This study aimed to develop a reliable, validated scale that can effectively assess the reflective ability of clinical nurses. METHODS: Study participants were 1,872 nurses. We developed an anonymous self-administered questionnaire consisting of 33 original scale items and used it to conduct a survey. The scale was developed based on a construct validity study using item analysis, exploratory factor analysis, and confirmatory factor analysis. Reliability was estimated with Cronbach's α values. Criterion-related validity was assessed using Pearson's correlation analysis. RESULTS: There were 1,292 responses (response rate, 69.0%). Responses from 1,262 subjects with no missing data were analyzed (valid response rate, 97.7%). Based on the item analysis and exploratory factor analysis, we developed a trial scale model with 3 factors and 25 items. We named the first factor (Factor 1) "Recall Their Own Nursing Practice," the second factor (Factor 2) "Reflect on Their Own Nursing Practice" and the third factor (Factor 3) "Expand Their Own Nursing Practice". This model was modified based on modification indices from the confirmatory factor analysis. A model with 3 factors and 19 items was developed. It had acceptable fit indices (goodness of fit index = 0.914; adjusted goodness of fit index = 0.890; comparative fit index = 0.949; root mean square error of approximation = 0.070). Cronbach's α coefficients were 0.962 for all scale items, 0.922 for Factor 1, 0.918 for Factor 2, and 0.885 for Factor 3. The correlation coefficient between the model and the Professional Identity Scale of Nurses was 0.506 (P < 0.01). CONCLUSION: We developed a reflective ability scale consisting of 3 factors and 19 items. We demonstrated its construct validity, reliability, and criterion-related validity. This scale can effectively assess the reflective ability of nurses.

Factors Affecting Clinical Nursing Competency: A Cross Sectional Study.

BACKGROUND: The purpose of this study was to elucidate the factors which affect the achievement of clinical nursing competency. METHODS: A survey was conducted on 717 nurses using an anonymous self-administered questionnaire. Their clinical nursing competency was assessed using the Clinical Nursing Competence Self-Assessment Scale (CNCSS). This study examined the factors affecting clinical nursing competency using regression analyses. A simple regression analysis was performed with the CNCSS as the objective variable. A multiple regression analysis was performed using the items for which the relationship was clarified as explanatory variables. RESULTS: The factors affecting the "basic nursing competency" were age, ease of taking time off, workplace with a clear vision, and good interpersonal relationships. The factors affecting the "competency in providing assistance commensurate with the patient's health status" were total years of experience, workplace with a clear vision, ease of taking time off, and use of acquired certifications. The factors affecting the "coordinating care environment and teamwork" were total years of experience, workplace with a clear vision, use of acquired certifications, and ease of taking time off. The factors affecting the "ability for professional growth in nursing practice" were use of acquired certifications, workplace with a clear vision, total years of experience, and ease of taking time off. CONCLUSION: For improvement of clinical nursing competency, the factors elucidated to be necessary were accumulation of experience as a nurse, a clear vision of goals, and a work environment with good interpersonal relationships and ease of getting days off. The way nurses make their nursing practice experience meaningful contributed toward their growth as nurses. It is important to train nurses through basic education and continued education with awareness of achievement and improvement of clinical nursing competency. Basic education should promote the ability to make clinical training experience meaningful and continuing education should enable nurses to continue to grow independently through reflection.

Effects of a Self-efficacy Theory-Based Training Program for Peers of Patients with Type 2 Diabetes.

BACKGROUND: Training peer leaders to deliver patient education is expected to be a low-cost approach to providing healthcare in urban-poor areas affected by a shortage of healthcare professionals. The purpose of this study was to examine the effects of a training program on the self-efficacy and knowledge of peer leaders with type 2 diabetes. METHODS: A single-group longitudinal survey with baseline, intervention, and follow-up periods was conducted at a diabetes clinic in a small municipality in Metro Manila, Philippines. The intervention, a self-efficacy theory-based training program for peer-leaders of diabetic patients conducted in August 2017, comprised hands-on learning, demonstrations, quizzes, role-playing, group sharing, physical exercise, and a buffet lunch. The primary outcome was participants' self-efficacy for management of their diabetes. Secondary outcomes were participants' knowledge of diabetes and levels of emotional distress, motivation, and confidence for guiding their peers, satisfaction with the training program, hemoglobin A1c, and quality of life. RESULTS: At 12 and 18 months after the intervention, participants' knowledge of diabetes was significantly increased compared with baseline (both P < 0.05). At earlier time points, an increasing, but not significant, trend was observed. The change in knowledge of diabetes from baseline to 18 months after intervention tended to be positively correlated with the change in self-efficacy (r = 0.594, P = 0.054). No significant differences were observed for any of the other outcomes, although the descriptive statistics showed an increasing trend for all of the outcomes except motivation. CONCLUSION: The training program significantly improved participants' knowledge of diabetes at 12 and 18 months after the training programs compared with baseline. A positive correlation between the changes in the levels of knowledge and self-efficacy suggested that the observed improvement of self-efficacy was facilitated by the improvement of knowledge of diabetes.

The Differences in Basic Social Competency and Relevant Factors Based on Years of Study Amongst University Nursing Students.

BACKGROUND: Basic social competency is defined as the fundamental ability necessary for working with diverse people in the workplace and community. This study aimed to clarify the differences in the basic social competency of university nursing students by year of study, and related factors. METHODS: The subjects were 305 first- to fourth-year university nursing students. A survey was conducted using a self-completed questionnaire. Analyses were performed by comparing basic social competency amongst different years of study, calculating correlation coefficients of occupational readiness and development of personalization and socialization with basic social competency, and multiple regression analysis of factors influencing basic social competency. RESULTS: The subjects analyzed were the 162 students who returned the questionnaire (the recovery rate was 53.1%, and the response rate was 100%). Basic social competency tended to decrease in second-year students and subsequently improved in fourth-year students. Specifically, the scores of Action and Teamwork were significantly high in fourth-year students. In addition, the correlation coefficient between occupational readiness and basic social competency was r = 0.566 (P = 0.01), r = 0.615 for the individual orientedness (P = 0.01), and r = 0.542 for the social orientedness (P = 0.01); and significant correlations were observed in these relevant factors. Multiple regression analyses revealed that basic social competency were influenced by occupational readiness, individual orientedness, and social orientedness (R 2 = 0.47, F = 15.14, P = 0.00). CONCLUSION: Basic social competency for university nursing students was significantly higher in fourth-year students, and the correlation with basic social competency was strong in the categories of occupational readiness and the development of personalization and socialization. It was suggested that clinical practice experiences promoted students' personal growth and socialization while preparing to take a nursing job and affected the development of basic social competency.

Impact of Organization and Career Commitment on Clinical Nursing Competency.

BACKGROUND: The majority of nurses are employed at medical institutions and acquire clinical competency through their work within their organization. Hands-on experience in the clinical setting is essential to enhance a nurse's clinical competence. The objective of this study was to determine the impact of commitment to the practical skills of nurses within Tottori prefecture. METHODS: We studied data from 916 nurses employed at 7 publicly-funded medical facilities (national and other public institutions). Data on basic information, clinical nursing competence, and commitment were collected via an anonymous self-administered questionnaire. RESULTS: A total of 672 valid questionnaires were analyzed. Mean clinical nursing competence scores showed a tendency to increase with years of experience. Scores increased from years 1 to 4, and then tended to plateau or decrease slightly thereafter up to around year 9. Mean commitment scores decreased from 1 to 2 years of experience to 3 to 4 years of experience. Other than "normative factors," mean scores tended to increase after 5 to 10 years of experience. Multiple regression analysis showed that "job involvement" at 1 to 2 years; "overall job satisfaction" at 5 to 9 years; "career commitment" at 10 to 19 years; and "job involvement" and "career commitment" at ≥ 20 years impacted results. No factors appeared to have an influence on nurses in their 3rd to 4th year of experience. CONCLUSION: Based on the concepts described above, self-assessment of nursing competence scores tended to improve with years of experience. Mean commitment scores tended to decrease after 3 to 4 years of experience and thereafter plateaued or increased. Organizational commitment has not clearly been shown to affect nursing competency, but the factors that affect this parameter changed with the length of experience. Results suggest support is needed in the 1st and 2nd years to help nurses adapt to the organization while in years 5 through 9, support that takes work-life balance into consideration is needed. This indicates support should change to meet the needs of each stage in a nurse's career. In years 3 to 4, it was suspected that the nurses' relationship with the organization weakened. Helping nurses forge a good relationship with their organization is believed to be effective in improving clinical competency in nurses with 5 or more years of experience.

A Conceptual Model for Quality of Life Among People with Type 2 Diabetes in the Philippines.

BACKGROUND: The increased prevalence of chronic diseases is a social issue in developing countries. METHODS: To create a conceptual model representing the quality of life of low-income people with type 2 diabetes in the Philippines, 117 low-income adult participants in a public support group were studied, and the Physical Component Summary (PCS) and Mental Component Summary (MCS) scores on quality of life (QOL) were analyzed in terms of their relationships with the following factors: basic attributes, physical factors (glycated hemoglobin level, complications, comorbidities, and symptoms), social factors (support, education, and financial status), and cognitive factors (knowledge, attitude, self-efficacy, and self-management behavior). RESULTS: Based on correlation coefficients among variables and goodness-of-fit test results through a path analysis, 2 models representing causal relationships were created, both of which showed sufficient goodness-of-fit. CONCLUSION: Glycated hemoglobin levels, knowledge of blood glucose levels, self-efficacy, and self-management behavior (exercise) influenced PCS scores, while age, glycated hemoglobin levels, neuropathy, knowledge of insulin, self-efficacy, and self-management behavior (exercise) influenced MCS scores. The influence of self-efficacy was prominent in both cases, providing an important insight for healthcare professionals to develop effective support methods.

Qualitative Analysis of the Psychosocial Adaptation Process in Children with Chronic Kidney Disease: Toward Effective Support During Transition from Childhood to Adulthood.

BACKGROUND: Pediatric chronic renal disease only shows abnormal values in a urinalysis in the initial stage, and subjective signs and symptoms are rare. If adolescents with chronic renal disease face a disease crisis combined with the usual developmental crisis, this may cause psychosocial maladaptation. We analyzed psychosocial adaptation in Japanese children with chronic renal disease in order to identify factors influencing healthy adaptation. METHODS: Ten children and adult patients with chronic kidney disease attending Tottori University Hospital, Japan in 2016 participated in a semi-structured interview (a modified version of the grounded theory approach) comprising questions about episodes since disease onset and thoughts/feelings at onset. RESULTS: Twenty-four concepts extracted from the data were sorted into 5 categories. These concepts and categories were expanded on an orthogonal axis with time and self-esteem in order to establish an adaptation model for children with chronic kidney disease. Category names are as follows. (Cat. 1: Emotional impact on being informed of disease, Cat. 2: Social challenges of treatment and resulting identity diffusion, Cat. 3: Emotional conflict on school return, Cat. 4: Resilience and related factors, Cat. 5: Re-establishment of identity). CONCLUSION: Since pediatric chronic renal disease has few manifestations, it is difficult for patients to accept. Children facing a chronic disease crisis plus adolescent developmental crisis may show identity diffusion. In order for children to re-establish their identity and adapt to society, factors supporting resilience are important. Key factors include school life, interactions with friends, counseling by adult mentors and family acceptance. Healthcare professionals need to provide age-appropriate information on renal disease and support patients.

Nursing Competency: Definition, Structure and Development.

Nursing competency includes core abilities that are required for fulfilling one's role as a nurse. Therefore, it is important to clearly define nursing competency to establish a foundation for nursing education curriculum. However, while the concepts surrounding nursing competency are important for improving nursing quality, they are still not yet completely developed. Thus, challenges remain in establishing definitions and structures for nursing competency, competency levels necessary for nursing professionals, training methods and so on. In the present study, we reviewed the research on definitions and attributes of nursing competency in Japan as well as competency structure, its elements and evaluation. Furthermore, we investigated training methods to teach nursing competency.

Changes resulting from reflection dialogues on nursing practice.

BACKGROUND: Reflection is defined here as a process by which, through self-conversation, one's self and one's behavior acquire meaning. However, people have limitations in terms of what they can express and be aware of during reflection. This finding points to the importance of facilitators. The purpose of this study was to determine what changes can be brought about through reflection dialogues on nursing practice. METHODS: The Participants were 9 nurses who worked at three institutions in City A, each with about 200 beds. Workplace topics were examined through self-reflections and reflection dialogues. The depth of reflection was assessed using the three levels of reflection described by Mezirow-{reflecting on the content}, {reflecting on the process} and {reflecting on the assumptions}. RESULTS: In reflecting on nursing practice, the participants were also divided into those who had already reached the highest level, {reflecting on assumptions}, via self-reflection, and those who remained at the level of {reflecting on processes}, despite the use of reflection dialogues. CONCLUSION: The development of reflective thinking on nursing practice was connected not only to the participants' desire to explore ways of accepting their individual experiences, but may also be connected to whether or not they are able to question themselves about their thoughts and preconceptions about nursing work.

Effect of "rose essential oil" inhalation on stress-induced skin-barrier disruption in rats and humans.

In stressed animals, several brain regions (e.g., hypothalamic paraventricular nucleus [PVN]) exhibit neuronal activation, which increases plasma adrenocorticotropic hormone (ACTH) and glucocorticoids. We previously reported that so-called "green odor" inhibits stress-induced activation of the hypothalamo-pituitary-adrenocortical axis (HPA axis) and thereby prevents the chronic stress-induced disruption of the skin barrier. Here, we investigated whether rose essential oil, another sedative odorant, inhibits the stress-induced 1) increases in PVN neuronal activity in rats and plasma glucocorticoids (corticosterone [CORT] in rats and cortisol in humans) and 2) skin-barrier disruption in rats and humans. The results showed that in rats subjected to acute restraint stress, rose essential oil inhalation significantly inhibited the increase in plasma CORT and reduced the increases in the number of c-Fos-positive cells in PVN. Inhalation of rose essential oil significantly inhibited the following effects of chronic stress: 1) the elevation of transepidermal water loss (TEWL), an index of the disruption of skin-barrier function, in both rats and humans and 2) the increase in the salivary concentration of cortisol in humans. These results suggest that in rats and humans, chronic stress-induced disruption of the skin barrier can be limited or prevented by rose essential oil inhalation, possibly through its inhibitory effect on the HPA axis.

"Green odor" inhalation by rats down-regulates stress-induced increases in Fos expression in stress-related forebrain regions.

In the present study, on rats, a quantitative analysis of Fos protein immunohistochemistry was performed as a way of investigating the effects of inhalation of green odor (a mixture of equal amounts of trans-2-hexenal and cis-3-hexenol) on the neuronal activations in stress-related forebrain regions induced by acute and repeated stress. Rats were exposed to restraint stress for 90 min each day for 1, 2, 4, 7, or 11 consecutive days. The hypothalamic paraventricular nucleus (PVN), amygdala, hippocampus and paraventricular thalamic nucleus (PVT) were examined. Both acute and repeated restraint stress increased Fos-positive cells in the entire hypothalamic PVN, in the central and medial amygdala, and in PVT, although these responses declined upon repeated exposure to such stress. The stress-induced Fos responses were much weaker in rats that inhaled green odor during each day's restraint. No increases in Fos-positive cells were observed in the hippocampus in acutely stressed rats. The Fos-immunoreactive response to acute stress shown by the piriform cortex did not differ significantly between the vehicle+stress and green+stress groups. Green odor had inhibitory effects on the stress-induced corticosterone response, body-weight loss, and adrenal hypertrophy. These results suggest that in rats, green odor inhalation may, in an as yet unknown way, act on the brain to suppress activity in the neuronal networks involved in stress-related responses (such as activation of the hypothalamo-pituitary-adrenocortical axis and activation of the sympathetic nervous system, as well as stress-induced fear responses).

"Green odor" inhalation reduces the skin-barrier disruption induced by chronic restraint stress in rats: physiological and histological examinations.

We investigated whether inhalation of green odor (a mixture of equal amounts of trans-2-hexenal and cis-3-hexenol) prevents the skin-barrier disruption induced by chronic restraint stress in rats. To this end, transepidermal water loss (TEWL) was measured as an index of the disruption of skin-barrier function, whereas light- and electron-microscope examinations were performed to observe histological changes in the skin of the stressed animals. In addition, the effects on TEWL induced by chronic administration of a glucocorticoid, dexamethasone (DEX), were examined. Chronic restraint stress (8 h per day for 14 days) increased TEWL (vehicle + stress group). This effect (and the chronic stress-induced increase in adrenal weight) was prevented in rats that inhaled green odor at the beginning of each day's restraint (2 h each day for 14 days; green odor + stress group). Electron-microscope studies revealed that rats in the green odor + stress group possessed sufficient intercorneocyte lipids to create an effective skin barrier, although these had apparently been decreased in the vehicle + stress group. Daily administration of DEX for 14 days increased TEWL. The present results suggest that chronic stress-induced disruption of the skin barrier in rats can be reduced or prevented by green odor (possibly at least in part through an inhibitory effect on the stress-induced activation of the hypothalamo-pituitary-adrenocortical axis).

Systemic administration of lipopolysaccharide upregulates angiotensin II expression in rat renal tubules: immunohistochemical and ELISA studies.

We investigated whether angiotensin II (AII) peptide is induced in the rat kidney under endotoxemic conditions. Immunohistochemistry revealed strong AII-like immunoreactivity in the renal tubules of rats given high-dose lipopolysaccharide (LPS; 1000 microg/kg) intraperitoneally (i.p.). AII-like immunoreactivity in renal tubules was slight at 1h after the LPS injection, but marked at 3 h. There were few signals in the kidney in saline-injected control rats. When injected at 0.1, 10, or 1000 microg/kg i.p., LPS-induced a dose-related increase in AII-like immunoreactivity in renal tubules that was unaffected by treatment with the prostaglandin-synthesis blocker indomethacin. ELISA measurement of the AII concentration in the whole kidney supported the above findings. These results suggest that systemically administered LPS induces AII peptide expression in renal tubules by a prostaglandin-independent mechanism.