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The association between doctors' long working hours and the seriousness of adverse events with high patient impact has not been fully confirmed. Most previous studies were based on work hour regulations using more than 80 hours per week as an indicator of long working hours. We aimed to assess the association using a shorter indicator as the cut-off for long working hours among hospital doctors including senior doctors. This cross-sectional study used 12,245 adverse event reports from the Japan Council for Quality Health Care. We defined long working hours as 55 hours or more in the week before the adverse event and assessed the association with the seriousness of adverse events with high patient impact. The results showed that doctors working 55 or more hours in the preceding week were more likely to be involved in serious adverse events than those working fewer hours (odds ratio (OR) 1.22, 95% confidence interval (CI): 1.12-1.32). This association remained significant after adjusting for all covariates (OR 1.18, 95% CI: 1.08-1.28). Senior doctors were more likely to be involved in serious adverse events. Long working hours among doctors were associated with the seriousness of adverse events.
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Background: Achieving gender equality is an important goal in Japan. Consequently, this study aimed to examine gender differences in a series of associations between job demands or resources and job performance mediated by work engagement (WE) in the motivational process of the job demands-resources model. Methods: This study recruited 671 non-manual workers (260 men and 411 women) through an online survey. The measured variables were demographic information, job demands or resources, WE, and job performance. Multiple-group structural equation modeling was used to analyze the data. Results: Regarding the level of job demands or resources and WE, no significant difference was observed between men and women. Whereas, job performance was significantly higher in women than in men. Additionally, multiple-group structural equation modeling indicated that the model that imposed on all path coefficients for equality constraints had a better fit, and consequently, no gender differences. Conclusion: Although the motivational process indicated no gender differences, job performance was higher in women than in men due to the management of a gender-equal and friendly work environment. Further comprehensive examinations, that use other variables not included in the present study, are required to understand women's high job performance.
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BACKGROUND: A previous study has shown that Japanese individuals generally exhibit behavior that suppresses the expression of positive emotions, which are strongly affected by affectivity traits. In the present study, to clarify the relationship between affectivity traits and work engagement (WE) or work-related psychosocial factors among Japanese workers, we compared it to the association between psychological distress and these same factors. METHODS: A total of 1,000 full-time Japanese regular workers responded to an online survey that measured demographic variables, negative and positive affectivity, job demands and resources, WE, and psychological distress. A hierarchical multiple regression analysis was conducted separately, which used WE and psychological distress as dependent variables. RESULTS: The proportion of variance explained by negative and positive affectivity was lower for WE than for psychological distress. However, the proportion of variance defined by job demands and resources was higher for WE than for psychological distress. The proportion of variance explained by all variables for negative and positive affectivity and job demands and resources, and their interactions was approximately equal for WE and psychological distress. CONCLUSION: These results emphasize when researchers aim to evaluate the change of psychosocial factors in the workplace, such as improving the workplace environment among Japanese workers, it might be beneficial to measure positive indicators in addition to negative indicators. Furthermore, enriching job resources would be effective in improving WE and alleviating psychological distress.
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Distrés Psicológico , Compromiso Laboral , Humanos , Pueblos del Este de Asia , Estrés Psicológico/psicología , Lugar de Trabajo/psicología , Encuestas y CuestionariosRESUMEN
INTRODUCTION: We explore job satisfaction among Japanese midwives working in different institutions within the Tokyo metropolitan area and relate this to midwives' age. METHODS: The study involved a questionnaire survey of 423 midwives working in 113 general hospitals, 70 clinics, and 58 midwifery centers in the Tokyo Metropolitan Area of Japan. The questionnaire consisted of items related to demographic and job satisfaction. Questionnaires were returned by 199 participants (47%). RESULTS: Of the 199 midwives, 142 worked in general hospitals (71%), 26 worked in maternity clinics (13%), and 31 worked in midwifery centers (16%). Factor analysis extracted six job satisfaction factors labelled as: F1 'midwifery services', F2 'interpersonal relations', F3 'rewarding and autonomy', F4 'working environment', F5 'working conditions', and F6 'collaboration with doctors'. Job satisfaction scores for all factors were the highest among midwives working in midwifery centers, followed by those working in maternity clinics and hospitals. Job satisfaction of F1 and F3 of those working in midwifery centers was significantly higher than those working in hospitals and maternity clinics for the younger age group, while the scores of those working in maternity clinics became higher and closer to those working in midwifery centers for other age groups. CONCLUSIONS: Job satisfaction of midwives varies by different institutions, particularly lowest for those working in hospitals than those working in midwifery clinics and centers. It is necessary to devise useful strategies for midwives in hospitals to enhance their satisfaction with midwifery services and to feel rewarded by and autonomy at work.
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OBJECTIVES: This study examined the effectiveness of a newly developed work-family life support program on the work-family interface and mental health indicators among Japanese dual-earner couples with a preschool child(/ren) using a randomized controlled trial with a waitlist. METHODS: Participants who met the inclusion criteria were randomly allocated to the intervention or the control groups (n = 79 and n = 85, respectively). The program comprised two 3-h sessions with a 1-month interval between them and provided comprehensive skills by including self-management, couple management, and parenting management components. The program sessions were conducted on weekends in a community center room with 3-10 participants. Outcomes were assessed at baseline, 1-month, and 3-month follow-ups. Primary outcomes were work-family balance self-efficacy (WFBSE), four types of work-family spillovers (i.e., work-to-family conflict, family-to-work conflict, work-to-family facilitation, and family-to-work facilitation), psychological distress, and work engagement reported by the participants. RESULTS: The program had significantly pooled intervention effects on WFBSE (P = .031) and psychological distress (P = .014). The effect sizes (Cohen's d) were small, with values of 0.22 at the 1-month follow-up and 0.24 at the 3-month follow-up for WFBSE, and -0.36 at the 3-month follow-up for psychological distress. However, the program had nonsignificant pooled effects on four types of work-family spillovers and work engagement. CONCLUSIONS: The program effectively increased WFBSE and decreased psychological distress among Japanese dual-earner couples with a preschool child(/ren).
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Salud Mental , Distrés Psicológico , Equilibrio entre Vida Personal y Laboral , Humanos , Pueblos del Este de Asia , Apoyo Familiar , Padres , EmpleoRESUMEN
To clarify the combined effect of the sub-factors of organizational commitment, this study examined the relationships between organizational commitment profiles and work engagement, psychological distress, and turnover intention among nurses. A cross-sectional survey was conducted; 455 nurses (38 men and 417 women) were included in the statistical analysis. We extracted six clusters through k-means cluster analysis and applied a one-way analysis of variance and χ2 test for work engagement, psychological distress, and turnover intention. Consequently, significant differences were found in work engagement and turnover intention (both p<0.05), and no significant difference was found in psychological distress. These results indicate the formation of affective and normative commitment among nurses in working energetically or preventing turnover. Additionally, no negative effects related to increases in continuance commitment were identified in this study.
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Personal de Enfermería en Hospital , Distrés Psicológico , Masculino , Humanos , Femenino , Intención , Personal de Enfermería en Hospital/psicología , Compromiso Laboral , Estudios Transversales , Satisfacción en el Trabajo , Reorganización del Personal , Encuestas y CuestionariosRESUMEN
OBJECTIVE: There is little evidence that workplace social support can relieve workers' mental health problems. Therefore, we examined whether social support from coworkers and supervisors was associated with reduced serious psychological distress among employees. METHODS: We used two-wave panel data from 13 Japanese companies. The baseline survey was conducted in 2011, and the follow-up survey 1 year later. From 9889 respondents, we selected 759 who had psychological distress at baseline, defined as ≥13 on the Kessler Psychological Distress Scale (K6). RESULTS: Increased coworker support was significantly associated with employees' reduced psychological distress (odds ratio, 3.51; 95% confidence interval, 2.17 to 5.68). The association between increased supervisor support and reduced psychological distress was nonsignificant (odds ratio, 1.32, 95% confidence interval, 0.85 to 2.04). CONCLUSION: Encouraging coworker support may contribute to the secondary prevention of mental health problems among employees.
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Distrés Psicológico , Lugar de Trabajo , Humanos , Lugar de Trabajo/psicología , Estudios de Cohortes , Estrés Psicológico/psicología , Apoyo Social , Encuestas y Cuestionarios , JapónRESUMEN
OBJECTIVE: This study aimed to obtain suggestions for new organizational-level item pools that companies could utilize to accomplish management philosophy and mission statements in the context of survey and work environment improvements for the national Stress Check Program. METHODS: A qualitative study was conducted using unsupervised learning. A large amount of text data related to management philosophy and mission statements were collected, that is, management messages described on the websites of all companies listed on the Tokyo Stock Exchange. For the main analysis, topic modeling was performed on the nouns from the management messages using Latent Dirichlet Allocation (LDA) to build a model consisting of 10 latent topics, each represented by a group of the 10 most frequently reoccurring nouns. Each group of nouns was qualitatively summarized based on the topic model. RESULTS: In total, 22 524 nouns were extracted from the management messages of 3575 companies. A topic model consisting of 10 latent topics was constructed using the LDA. The suggestion for new item pools included new technologies, business plans/strategies, company shareholders, health/happiness/wealth, profits/sales, development of society, a sustainable society, safety and security, customer/consumer satisfaction, corporate social responsibility, fairness, transparency, and human rights. CONCLUSION: The suggestions for potential item pools were derived from management philosophy and mission statement that are not covered in the existing survey. The suggestions could be useful for motivating employers to implement work environment improvement. Future studies need to make definite items and investigate whether they correlate to job stressors and mental health among workers.
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Aprendizaje Automático no Supervisado , Lugar de Trabajo , Comercio , Humanos , Filosofía , Responsabilidad SocialRESUMEN
The purposes of this meta-analysis were (1) to examine the associations between work engagement (WE) and the personality dimensions of five-factor model and (2) to determine how much variance in WE is explained by these five factors. We performed a database search for studies related to personality traits and WE, and 36 papers that reported correlation coefficients were selected for the meta-analysis. After correcting for publication bias using the trim-and-fill method, conscientiousness had the strongest association with WE (ρ=0.41), followed by extraversion and openness to experience (0.38), neuroticism (-0.36), and agreeableness (0.27). Moreover, 30% of the WE variance could be explained by the five-factor model (R2=0.33, 95%CI=0.26-0.49) according to a path analysis using the weighted average correlation for unreliability. This proportion was higher than that from a previous meta-analysis of job satisfaction and job performance and was lower than that of personality and WE. Thus, to enhance WE, it is necessary to evaluate both the personality and the psychosocial work environment in detail.
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Extraversión Psicológica , Compromiso Laboral , Humanos , Satisfacción en el Trabajo , Neuroticismo , PersonalidadRESUMEN
BACKGROUND: This study aimed to examine the effects of nurses' work-life balance (WLB), job demands and resources, and organizational attachment on their work engagement (WE). The second aim was to shed light on whether the relationships among WLB, job demands, resources, and WE are modulated by organizational attachment. METHODS: In total, 425 nurses working in a university hospital responded to the questionnaire. The primary statistical analysis method was hierarchical multiple regression with WE as the dependent variable. RESULTS: In the model in which all variables were applied, affective commitment (AC) (ß = 0.41), family-to-work positive spillover (ß = 0.25), and number of children (ß = 0.13) were found to have a significant association with WE. Family-to-work negative spillover (FWNS) and AC had significant interaction effects. The result suggests that when AC was low, WE tended to decline further due to FWNS; however, when AC was high, WE did not change due to the effect of FWNS. CONCLUSION: These results confirmed that to improve nurses' WE, hospital organizations should implement initiatives to facilitate WLB that considers nurses' household roles. Furthermore, high organizational attachment buffered the home's negative influence on work, thereby helping nurses work energetically.
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This study examines how working parents' work attitudes (i.e., workaholism and work engagement) are associated with their child's psychological well-being. Based on the Spillover-Crossover model (SCM), we hypothesize that (a) work-to-family spillover (i.e., work-to-family conflict and facilitation) and (b) employee happiness will sequentially mediate the relationship between parents' work attitudes and their child's emotional and behavioral problems. A cross-sectional survey was conducted among Japanese dual-earner couples with pre-school child(ren). On the basis of valid data from 208 families, the hypothesized model was tested using structural equation modeling. For both fathers and mothers simultaneously, workaholism was positively related to work-to-family conflict, which, in turn, was negatively related to happiness. In contrast, work engagement was positively related to work-to-family facilitation, which, in turn, was positively related to happiness. Fathers' and mothers' happiness, in turn, were negatively related to their child's emotional and behavioral problems. Results suggest that parents' workaholism and work engagement are related to their child's emotional and behavioral problems in opposite ways, whereby parents' spillover and happiness mediate this relationship. These findings support the SCM and suggest that decreasing workaholism and improving work engagement may not only improve employees' happiness, but also decrease their child's emotional and behavioral problems.
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Protección a la Infancia , Conflicto Familiar , Compromiso Laboral , Adulto , Niño , Salud Infantil , Preescolar , Estudios Transversales , Padre , Femenino , Humanos , Masculino , Persona de Mediana Edad , Madres , Carga de TrabajoRESUMEN
OBJECTIVE: The role of isolated nasal surgery for obstructive sleep apnea (OSA) patients with nasal obstruction, especially for an intolerance for continuous positive airway pressure (CPAP), is unclear. The aim of this study was to assess the effects of surgery for OSA patients with symptomatic nasal obstruction and CPAP intolerance. METHOD: Retrospectve comparative study.1037 OSA patients with apnea-hypopnea index (AHI) ≥ 20 were enrolled. Case-control study was performed between the male apnea patients undergoing nasal surgery: surgery group (n = 43) and the pair-matched apnea patients for age, sex, body mass index, and race: control group (n = 43). The surgery group suffering from nasal obstruction could not use continuous positive airway pressure, and the CPAP group free from nasal obstruction could use it successfully. RESULTS: In surgery group, surgery significantly decreased the nasal resistance and Epworth sleepiness scale scores without changing the AHI. Surgery significantly increased the nadir of oxygen saturation and shortened the apnea-hypopnea duration. Although all of the surgery group failed to use positive airway pressure preoperatively, the 40 patients of the 43 CPAP intolerance patients were able to use CPAP postoperatively. The resting three patients were cured OSA or changed the treatment to oral appliance(OA). For both groups, the cutoff nasal resistance for differentiating the failure of positive airway pressure and its success was 0.31 Pa/cm3/s. CONCLUSION: Isolated nasal surgery is effective for an intolerance of positive airway pressure in sleep apnea with nasal obstruction presumably by decreasing nasal resistance.
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Presión de las Vías Aéreas Positiva Contínua , Obstrucción Nasal/cirugía , Apnea Obstructiva del Sueño/cirugía , Adulto , Anciano , Estudios de Casos y Controles , Humanos , Hipertrofia , Masculino , Persona de Mediana Edad , Obstrucción Nasal/complicaciones , Tabique Nasal/cirugía , Procedimientos Quírurgicos Nasales , Curva ROC , Rinomanometría , Apnea Obstructiva del Sueño/etiología , Apnea Obstructiva del Sueño/terapia , Cornetes Nasales/patología , Cornetes Nasales/cirugíaRESUMEN
In a previous case report, we determined for the first time that uvulopalatopharyngoplasty (UPPP) does not change the volume of the upper airway but causes morphological changes in the entire upper airway. The objective of this study is to elucidate the mechanisms underlying the improvement in obstructive sleep apnea syndrome (OSAS) by UPPP. We present an additional case involving a patient with OSAS treated using UPPP. Morphological and numerical parameter changes after surgery were compared with the corresponding preoperative values. Anatomically accurate upper airway computational models were reconstructed from computed tomographic imaging data. In addition, computed fluid dynamics analysis was performed to reveal inhalation flow characteristics before and after UPPP and clearly assess the effect of UPPP on airflow patterns in the patient's upper airway. An important benefit of UPPP is the morphological changes in the entire upper airway, in addition to widening the restricted area. These morphological changes induce laminarization of the pharyngeal jet. To obtain sufficient efficacy of UPPP in OSAS, the morphological changes in the upper airway and the airflow pattern after the surgery must be controlled.
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OBJECTIVES: Cholesteatoma is a nonneoplastic destructive lesion of the temporal bone with debated pathogenesis and bone resorptive mechanism. Both molecular and cellular events chiefly master its activity. Continued research is necessary to clarify factors related to its aggressiveness. We aimed to investigate the expression of Ki-67, cytokeratin 13 (CK13) and cytokeratin 17 (CK17) in acquired nonrecurrent human cholesteatoma and correlate them with its bone destructive capacity. METHODS: A prospective quantitative immunohistochemical study was carried out using fresh acquired cholesteatoma tissues (n=19), collected during cholesteatoma surgery. Deep meatal skin tissues from the same patients were used as control (n=8). Cholesteatoma patients were divided into 2 groups and compared (invasive and noninvasive) according to a grading score for bone resorption based upon clinical, radiologic and intraoperative findings. To our knowledge, the role of CK17 in cholesteatoma aggressiveness was first investigated in this paper. RESULTS: Both Ki-67 and CK17 were significantly overexpressed in cholesteatoma than control tissues (P<0.001 for both Ki-67 and CK17). In addition, Ki-67 and CK17 were significantly higher in the invasive group than noninvasive group of cholesteatoma (P=0.029, P=0.033, respectively). Furthermore, Ki-67 and CK17 showed a moderate positive correlation with bone erosion scores (r=0.547, P=0.015 and r=0.588, P=0.008, respectively). In terms of CK13, no significant difference was found between cholesteatoma and skin (P=0.766). CONCLUSION: Both Ki-67 and CK17 were overexpressed in cholesteatoma tissue and positively correlated with bone resorption activity. The concept that Ki-67 can be a predictor for aggressiveness of cholesteatoma was supported. In addition, this is the first study demonstrating CK17 as a favoring marker in the aggressiveness of acquired cholesteatoma.
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CONTEXT: The scarcity of cross-national reports and the changes in Diagnostic and Statistical Manual version 5 (DSM-5) regarding panic disorder (PD) and panic attacks (PAs) call for new epidemiological data on PD and PAs and its subtypes in the general population. OBJECTIVE: To present representative data about the cross-national epidemiology of PD and PAs in accordance with DSM-5 definitions. DESIGN AND SETTING: Nationally representative cross-sectional surveys using the World Health Organization Composite International Diagnostic Interview version 3.0. PARTICIPANTS: Respondents (n = 142,949) from 25 high, middle, and lower-middle income countries across the world aged 18 years or older. MAIN OUTCOME MEASURES: PD and presence of single and recurrent PAs. RESULTS: Lifetime prevalence of PAs was 13.2% (SE 0.1%). Among persons that ever had a PA, the majority had recurrent PAs (66.5%; SE 0.5%), while only 12.8% fulfilled DSM-5 criteria for PD. Recurrent PAs were associated with a subsequent onset of a variety of mental disorders (OR 2.0; 95% CI 1.8-2.2) and their course (OR 1.3; 95% CI 1.2-2.4) whereas single PAs were not (OR 1.1; 95% CI 0.9-1.3 and OR 0.7; 95% CI 0.6-0.8). Cross-national lifetime prevalence estimates were 1.7% (SE 0.0%) for PD with a median age of onset of 32 (IQR 20-47). Some 80.4% of persons with lifetime PD had a lifetime comorbid mental disorder. CONCLUSIONS: We extended previous epidemiological data to a cross-national context. The presence of recurrent PAs in particular is associated with subsequent onset and course of mental disorders beyond agoraphobia and PD, and might serve as a generic risk marker for psychopathology.
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Encuestas Epidemiológicas/estadística & datos numéricos , Internacionalidad , Trastorno de Pánico/epidemiología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Asia/epidemiología , Australia/epidemiología , Estudios Transversales , Europa (Continente)/epidemiología , Femenino , Humanos , Masculino , México/epidemiología , Persona de Mediana Edad , Nueva Zelanda/epidemiología , Nigeria/epidemiología , Trastorno de Pánico/psicología , Prevalencia , América del Sur/epidemiología , Estados Unidos/epidemiología , Adulto JovenRESUMEN
This study explored the effect of workplace psychosocial factors (job demand, job control, and workplace social support) on dual-earner couples in Japan having additional children, using a prospective study design. We conducted a 2-year prospective cohort study with 103 dual-earner couples with preschool children in Japan, as part of the Tokyo Work-Family Interface Study II. We used multivariable logistic regression analyses to evaluate the prospective association of job strain (categorized into low-strain job, active job, passive job, and strain job groups) and workplace social support (high and low) with couples having additional children during the follow-up period, adjusting for age, for men and women separately. Men in the active job group (i.e., with high job demands and high job control) had a significantly higher odds ratio (OR) of having additional children during the follow-up period, after controlling for age (OR 9.07, 95% confidence interval: 1.27-64.85). No significant association between any workplace psychosocial factor and having additional children was confirmed among women. Having an active job may have a positive influence on having additional children among men in dual-earner couples.
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Composición Familiar , Apoyo Social , Estrés Psicológico/psicología , Lugar de Trabajo/psicología , Adulto , Preescolar , Femenino , Humanos , Japón , Modelos Logísticos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Factores Sexuales , Factores SocioeconómicosRESUMEN
Cholesteatoma is a cystic non tumorous lesion of the temporal bone that has the ability to destroy nearby structures by its power to cause bone resorption and as a result, fatal complications prevail. We aimed to conduct a comprehensive review for pathogenesis of acquired cholesteatoma, bone resorption mechanisms, and offer a future vision of this serious disease. We have reviewed different theories for pathogenesis of acquired cholesteatoma including the most relevant and updated ones with special emphasis on the mechanisms of bone resorption through Medline/PubMed research using the keywords 'aetiopathogenesis, bone resorption, acquired cholesteatoma, temporal bone, and cytokines.' In order to strengthen our study, we searched the reference lists of identified reviews. Cholesteatoma is a subject of debate among otolaryngologists since it was prescribed firstly. Over many decades, several theories were postulated for aetiopathogenesis of cholesteatoma with a tendency to follow more than one theory to explain the proper nature of that disease. Until now, the mechanism of bone resorption has yet to be more clarified. In the last century, a leap has occurred in the field of biomolecular cholesteatoma research which improved our knowledge about its pathophysiology and bone destructive mechanism. However, surgery is still the only available treatment. We conclude that discovery of new therapeutic choices for cholesteatoma other than surgery by the use of anti-growth, anti-proliferative, apoptotic agents as well as medications that antagonize osteoclastogenesis should be the main concern in the future clinical and experimental research work. Also, searching for predictors of the aggressiveness of cholesteatoma can affect the timing of intervention and prevent occurrence of complications.
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Objectives This study was aimed at examining whether caregivers' cognitive appraisal, coping strategies, and perceived influence on life vary according to care recipients' sex and caregivers' kinship (e.g., spouse, son, daughter, or daughter-in-law).Methods We contacted 1,110 relatively large visiting nursing stations in 37 prefectures, 83 of which agreed to participate in the study. Station managers were requested to select up to 20 families with an elderly person to care for. A questionnaire that included measures for caregivers' cognitive appraisal, coping strategies toward family caregiving, and caregivers' perception, which measures the perceptions of negative and positive influences on family life through caregiving, was administered to the 1,278 families selected by the nursing stations. From this pool, 1,020 questionnaires (79.8%) were returned, completed anonymously by primary caregivers.Results Two-way analysis of variance was used to analyze the care recipients' sex and kinship with primary caregivers. The analysis revealed significant interactions regarding the level of care required and approximately half of the scales measuring cognitive appraisal, coping strategies, and perceived influence on life. The level of care required was higher for male care recipients than for female care recipients when recipients were cared for by their daughters. Husbands caring for wives and daughters-in-law caring for fathers-in-law were more likely to feel "restricted in their social life," have difficulty "keeping pace" with caregiving, and have "negative influence on life." Husbands caring for wives felt less "personal growth through caregiving" than wives caring for husbands. Daughters caring for fathers perceived a lower "positive acceptance of caregiving role" than those caring for mothers. Husbands caring for wives tended not to seek "informal support." Care recipients' sex had little influence on caregivers' cognitive appraisal, coping strategies, and caregivers' perceptions of negative and positive influences on family life. Regarding the main effects of caregivers' kinship, spousal caregivers felt more anxious about continuous caregiving but felt more "fulfilled" and "positively accepted" in their caregiving role.Conclusion Cognitive appraisal and coping strategies toward family caregiving, and the caregivers' perceptions of negative and positive influences on life might vary according to care recipients' sex and caregivers' kinship. Our findings suggest the necessity for long-term care insurance services to incorporate not only care for the care recipients but also a strategy to deal with the psychological burden of family caregivers.
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Cuidadores , Adaptación Psicológica , Anciano , Anciano de 80 o más Años , Cognición , Femenino , Cuidados en el Hogar de Adopción , Humanos , Masculino , Persona de Mediana EdadRESUMEN
Objective. The aim of this study was to investigate the changes in velopharyngeal and glossopharyngeal airway morphology and volume after uvulopalatopharyngoplasty in three adult obstructive sleep apnea syndrome patients who had bilateral large tonsils using three-dimensional computed tomography. Case Report. All three patients (one male and two females) who presented with a history of heavy snoring and excessive daytime sleepiness were examined with overnight nocturnal polysomnography, which indicated moderate-to-severe obstructive sleep apnea syndrome. Because all patients had large tonsils, uvulopalatopharyngoplasty was expected to enlarge the pharyngeal airway. Polysomnography and three-dimensional computed tomography scanning were performed and compared, both before and 3 months after uvulopalatopharyngoplasty. Results. Unexpectedly, although the morphology of the glossopharyngeal airway clearly changed after UPPP, the volume changes in the velopharyngeal and glossopharyngeal airways were negligible.
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The purpose of the study was to investigate the association between parental workaholism and child body mass index (BMI) among Japanese dual-income families. In 2011, 379 dual-income families from urban Tokyo with children aged 0-5 years were recruited for a baseline survey, and 160 (42.2%) were followed up in 2012. Demographics, workaholism, work demands, work control, time spent with children, and parental and child weights and heights were assessed using a questionnaire. Structural equation modeling was performed to determine the association between maternal and paternal workaholism in 2011 and child BMI in 2012, considering the mediating effects of time spent with children. Paternal workaholism showed a direct significant positive association with child BMI after 1 year (standardized coefficient: 0.19; p < 0.001), while maternal workaholism was not associated with child BMI. Both maternal and paternal time spent with children did not mediate the association. Paternal work demands showed a strong positive association with workaholism but paternal work control did not. Paternal, but not maternal, workaholism was associated with an increase in child BMI over 1 year. Interventions that target workaholism by reducing paternal work demands might be effective in preventing overweight in offspring.