The relationship between dispositional empathy, psychological distress, and posttraumatic stress responses among Japanese uniformed disaster workers: a cross-sectional study

BACKGROUND

Disaster workers suffer from psychological distress not only through the direct experience of traumatic situations but also through the indirect process of aiding disaster victims. This distress, called secondary traumatic stress, is linked to dispositional empathy, which is the tendency for individuals to imagine and experience the feelings and experiences of others. However, the association between secondary traumatic stress and dispositional empathy remains understudied.

METHODS

To examine the relationship between dispositional empathy and mental health among disaster workers, we collected data from 227 Japan Ground Self-Defense Force personnel who engaged in international disaster relief activities in the Philippines following Typhoon Yolanda in 2013. The Impact of Event Scale-Revised and the Kessler Psychological Distress Scale were used to evaluate posttraumatic stress responses (PTSR) and general psychological distress (GPD), respectively. Dispositional empathy was evaluated through the Interpersonal Reactivity Index, which consists of four subscales: Perspective Taking, Fantasy, Empathic Concern, and Personal Distress. Hierarchial linear regression analyses were performed to identify the variables related to PTSR and GPD.

RESULTS

High PTSR was significantly associated with high Fantasy (identification tendency, β = 0.21, p < .01), high Personal Distress (the self-oriented emotional disposition of empathy, β = 0.18, p < .05), and no experience of disaster relief activities (β = 0.15, p < .05). High GPD was associated with high Personal Distress (β = 0.28, p < .001), marital status (married, β = 0.22, p < .01), being female (β = 0.18, p < .01), medical unit (β = 0.18, p < .05), and no experience of disaster relief activities (β = 0.13, p < .05).

CONCLUSIONS

Among Japanese uniformed disaster workers, high PTSR was associated with two subtypes of dispositional empathy: the self-oriented emotional disposition of empathy and high identification tendency, whereas high GPD was associated with high identification tendency. Educational interventions that aim to mitigate these tendencies might be able to relieve the psychological distress of disaster workers.

Effect of Addition of Styrene-Ethylene/Butylene-Styrene and the Type of Mica on the Mechanical Properties of Mica-Filled Polyethylene/Polypropylene Blends

The mechanical properties of polyethylene (PE)/polypropylene (PP)/styrene-ethylene/butylene-styrene (SEBS)/mica composites were investigated as a model composition. Four types of mica with different particle sizes and different aspect ratios were used. These composites were extruded by a twin-screw extruder and subsequently injection molded, and their mechanical properties, including their tensile, bending, and impact properties were evaluated. The addition of mica to PE/PP/SEBS effectively improved its mechanical properties; the addition of SEBS as a compatibilizer likewise enhanced the mechanical properties compared with those of PE/PP composites without SEBS. The use of larger average particle size and higher aspect ratio mica, such as M-35, M-27, and P-33, effectively increased the tensile and bending properties of the PE/PP/SEBS/mica composites. The morphologies of the composites with an added mica as observed by scanning electron microscopy, showed good dispersion between the matrix polymer and the mica.

Prospective predictors of exacerbation status in severe asthma over a 3-year follow-up

BACKGROUND

A predisposition to exacerbations is being recognized as a distinct phenotype with "previous exacerbations" representing the strongest clinical factor associated with future exacerbation. Thus, to identify additional novel biomarkers associated with asthma exacerbations, "past exacerbation status" must be included as a confounding factor.

OBJECTIVE

This study aimed to characterize the clinical and biomarker features associated with asthma exacerbations in severe asthma.

METHODS

We evaluated clinical parameters from 105 severe asthmatics yearly for 3 years, as well as their exacerbation status. We classified the subjects into 3 groups: (i) consistent non-exacerbators (CNE, subjects who did not experience any exacerbation over the 3-year period); (ii) consistent frequent exacerbators (CFE, subjects with frequent exacerbation, defined as those who had 2 or more exacerbations within 1 year, throughout the 3-year period); and (iii) intermittent exacerbators (IE). We conducted multivariate analysis for comparisons among the groups for multiple factors, including several Th2-related biomarkers, in addition to the "past exacerbation status."

RESULTS

Thirty-nine subjects were classified as CNE, 15 as CFE, and 51 as IE. Frequent exacerbations in the previous year predicted exacerbations for the following year (P < .001). Among the several Th2-related biomarkers, only FeNO was associated with exacerbation status. When we analysed the data after the second visit, the impact of FeNO on predicting future exacerbation remained significant, even after considering the exacerbation status during the first year (P < .05).

CONCLUSIONS AND CLINICAL RELEVANCE

Measurement of FeNO has a significant potential to predict future asthma exacerbation, which is independent of the "past exacerbation history."

Screening for Middle East respiratory syndrome coronavirus among febrile Indonesian Hajj pilgrims: A study on 28,197 returning pilgrims

There were 211,000 Indonesian Hajj pilgrims going to Mecca through 11 main airports in 2015 who were at risk of contracting the Middle East respiratory syndrome coronavirus (MERS-CoV). We aimed to find out whether there was any occurrence of MERS-CoV by performing screening on 28,197 returning pilgrims. Those with a body temperature of > 38 °C and respiratory symptoms were sent to the airport clinic to have an oropharyngeal swab and a bacterial culture. Fifteen pilgrims had fever (> 38 °C) accompanied by respiratory symptoms; of these, 12 patients were diagnosed with upper and lower respiratory tract infections and three patients with pneumonia. However, none of them were found to be infected with MERS-CoV. The bacterial cultures showed evidence of normal flora growth.

Differential effects of voluntary wheel running and toy rotation on the mRNA expression of neurotrophic factors and FKBP5 in a post-traumatic stress disorder rat model with the shuttle-box task

Life-threatening experiences can result in the development of post-traumatic stress disorder. We have developed an animal model for post-traumatic stress disorder (PTSD) using a shuttle box in rats. In this paradigm, the rats were exposed to inescapable foot-shock stress (IS) in a shuttle box, and then an avoidance/escape task was performed in the same box 2 weeks after IS. A previous study using this paradigm revealed that environmental enrichment (EE) ameliorated avoidance/numbing-like behaviors, but not hyperarousal-like behaviors, and EE also elevated hippocampal brain-derived neurotrophic factor (BDNF) expression. However, the differential effects of EE components, i.e., running wheel (RW) or toy rotation, on PTSD-like behaviors has remained unclear. In this experiment, we demonstrated that RW, toy rotation, and EE (containing RW and toy rotation) ameliorated avoidance/numbing-like behaviors, induced learning of avoidance responses, and improved depressive-like behaviors in traumatized rats. The RW increased the hippocampal mRNA expression of neurotrophic factors, especially BDNF and glial-cell derived neurotrophic factor. Toy rotation influenced FK506 binding protein 5 mRNA expression, which is believed to be a regulator of the hypothalamic-pituitary-adrenal (HPA)-axis system, in the hippocampus and amygdala. This is the first report to elucidate the differential mechanistic effects of RW and toy rotation. The former appears to exert its effects via neurotrophic factors, while the latter exerts its effects via the HPA axis. Further studies will lead to a better understanding of the influence of environmental factors on PTSD.

Extremely permeable porous graphene with high H2/CO2 separation ability achieved by graphene surface rejection

Fabrication of a graphene separation sheet is difficult because of the necessity for leakage-free graphene transfer onto a substrate. In this study, porous graphene sheets with thicknesses of one, two, and four layers were directly fabricated on stainless-steel mesh substrates and demonstrated to display high separation ability for H₂, CO₂, and CH₄. The single-layer graphene sample exhibited higher permeance for these molecules than double- and four-layer graphene and displayed similar high selectivity to that of other porous materials. Permeance was proportional to molecular velocity and inversely proportional to interaction strength with graphene; molecular size-dependent permeance was not seen. Molecules that interacted strongly with graphene were attracted to the graphene surface, which hindered permeation. Such graphene surface rejection allowed graphene containing larger pores than the molecular size to provide both high molecular permeance and selectivity. The relationship between the permeance of porous graphene for H₂ and H₂/CO₂ with selectivity suggested that its permeance was higher than that of other materials with high separation performance. Therefore, the porous graphene samples separated molecules with extremely high permeance by graphene surface rejection.

The Psychological Impact of the Great East Japan Earthquake on Japan Ground Self-Defense Force Personnel: A Three-Wave, One-Year Longitudinal Study

OBJECTIVE

Approximately 70,000 Japan Ground Self-Defense Force (JGSDF) personnel were dispatched in the wake of the 2011 Great East Japan Earthquake and the tsunami and nuclear disaster that followed. This study was conducted to evaluate the mental health of the JGSDF personnel and the correlates.

METHODS

Data collected from 56,753 participants at three time points (one, six, and 12 months after mission completion) were analyzed. Those who scored 25 or more points on the Impact of Events Scale-Revised (IES-R) and the Kessler Psychological Distress Scale (K10) were allocated into the high posttraumatic stress response (high-PTSR) group, and the high general psychological distress (high-GPD) group, respectively.

RESULTS

The multiple logistic regression analysis identified the following factors as the significant risk factor related to high-PTSR or high-GPD status, with odds ratios of 2.0 or higher: deployment length of three or more months, being personally affected by the disaster, and being overworked continuously for three or more months after mission completion. No significant association was observed for duties with radiation exposure risk.

CONCLUSIONS

Our findings suggest that disaster workers may be able to conduct disaster relief activities more safely with mission-related considerations of shorter deployment length and recognizing the effects on personnel personally affected by the disaster, in addition to avoiding overworking personnel after mission completion.

Construct validity and reliability of the Tachikawa Resilience Scale in the Japan Ground Self-Defense Force personnel

PURPOSE

The importance of resilience as a mental health outcome has been reported in recent occupational health studies, although resilience is yet to be assessed in the Japan Ground Self-Defense Force (JGSDF) population. Our objective was to test whether the Tachikawa Resilience Scale (TRS), developed to measure the resilience of Japanese individuals, is useful for evaluating the resilience of the JGSDF.

PATIENTS AND METHODS

We performed a cross-sectional study of 353 JGSDF peacekeeping personnel engaged in the United Nations Mission in the Republic of South Sudan from November 2015 to May 2016. We evaluated resilience using two psychological measures: the TRS and the Resilience Competence Scale - Japanese Short Version (RCS-JS). To verify the construct validity of the TRS, we performed exploratory factor analysis and confirmatory factor analysis. We subsequently conducted hierarchical multivariate regression analysis to evaluate the relationship of the TRS and the RCS-JS with psychological distress measured by the Japanese version of the Kessler Psychological Distress Scale.

RESULTS

Of those recruited, 281 (79.6%) agreed to participate. The exploratory factor analysis revealed a one-factor model of the TRS. The confirmatory factor analysis model showed good fit (ratio of χ ² to the degrees of freedom =1.409, P=0.105, comparative fit index =0.994, root mean square error of approximation =0.038). Both the TRS and the RCS-JS showed a significant inverse correlation with the Kessler Psychological Distress Scale, and the regression coefficient of the TRS was equivalent to that of the RCS-JS.

CONCLUSION

We confirmed the construct validity and reliability of the TRS when applied to the JGSDF, and demonstrated the usefulness of the TRS in this population.

Designing the ammonium cation to achieve a higher hydrophilicity of bistriflimide-based ionic liquids

Development of water soluble bistriflimide-based ionic liquids and molecular dynamics simulations to unveil the underlying molecular details.

Enhanced dissolution of ibuprofen using ionic liquids as catanionic hydrotropes

Ionic liquids as powerful hydrotropes for ibuprofen, where both cation and anion may contribute to the hydrotropic mechanism in a synergistic manner.

A Case of Successful Simultaneous Pancreas-Kidney Transplantation Using the Injured Pancreas Graft

OBJECTIVE

Graft injuries sometimes occur and may cause complications such as the leakage of pancreatic secretions, which is often lethal. We report our experience of a case of successful simultaneous pancreas-kidney transplantation using injured pancreas graft.

PATIENTS AND METHODS

The recipient was a 57-year-old woman with type 1 diabetes mellitus, and the donor was a 30-year-old man with a brain injury. In the donation, the pancreas parenchyma, splenic artery, and gastroduodenal artery were injured iatrogenically. We therefore reconstructed these arteries using vessel grafts and then performed simultaneous pancreas-kidney transplantation.

RESULTS

Five days after transplantation, we noted a high titer of amylase in the ascites; therefore, we performed an urgent laparotomy. The origin of the amylase was the injured pancreatic parenchyma, and continued washing and drainage were carried out. We reconstructed the duodenojejunostomy using the Roux-en-Y technique to separate the passage of food from the pancreas graft to prevent injury to other organs due to exposure to pancreatic secretions. Thereafter, we inserted a decompression tube into the anastomosis thorough the blind end of the jejunum. Finally, we inserted 3 drainage tubes for lavage. Following this procedure, the patient recovered gradually and no longer required hemodialysis and insulin therapy. She was discharged from our hospital 56 days after transplantation.

CONCLUSION

The restoration of the injured graft was possible by management of pancreatic secretions and use of the donor's vessel grafts. Shortage of donors is a problem throughout the world; thus, it is important to use injured grafts for transplantation if possible.

Role of Neuron-Glial Interaction Mediated by IL-1β in Ectopic Tooth Pain

Although many reports have demonstrated that ectopic pain develops in the orofacial region following tooth pulp inflammation, which often causes misdiagnosis and inappropriate treatment for patients with pulpitis, the precise mechanism remains unknown. In the present study, we hypothesized that the functional interaction between satellite glial cells and neurons mediated by interleukin 1β (IL-1β) in the trigeminal ganglion (TG) is involved in ectopic orofacial pain associated with tooth pulp inflammation. The digastric muscle electromyogram (D-EMG) activity elicited by capsaicin administration into the maxillary second molar tooth pulp was analyzed to evaluate the noxious reflex and was significantly increased in rats with inflammation of the maxillary first molar (M1) versus rats injected with saline. A significant increase in the expression of connexin43 (Cx43), a gap junction containing protein, was observed in activated satellite glial cells surrounding second molar-innervating neurons in the TG after M1 pulpitis. Daily administration of Gap26, a Cx43 mimetic peptide and inhibitor, in the TG significantly suppressed the enhancement of capsaicin-induced D-EMG activity and the percentage of Fluoro-Gold (FG)-labeled cells encircled by glial fibrillary acid protein-immunoreactive (IR) + Cx43-IR cells after M1 pulp inflammation ( P < 0.01). The percentage of FG-labeled cells encircled by glial fibrillary acid protein-IR + IL-1β-IR cells, IL-1 type I receptor-IR cells labeled with FG, and TRPV1-IR cells labeled with FG significantly increased after M1 pulp inflammation ( P < 0.01). Daily administration of IL-1ra, an IL-1 receptor antagonist, into the TG significantly reduced the enhancement of capsaicin-induced D-EMG activity and the percentage of TRPV1-IR neurons labeled with FG after M1 pulp inflammation ( P < 0.01). The present findings suggest that satellite glial cell is activated in the TG via activated gap junctions composed of Cx43 following tooth pulp inflammation, which leads to the hyperactivation of remote neurons via IL-1β mechanisms and results in ectopic tooth pulp pain in the adjacent tooth.