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A Special Needs Dental Center （hereafter referred to as the Center） was established at Showa University Dental Hospital in April 2012 to treat patients who need special care. In cooperation with the Division of Dentistry for Persons with Disabilities, the Division of Hygiene and Oral Health is mainly engaged in the treatment of patients with eating and swallowing disorders. It has been five years since the establishment of the Center. The present study was aimed to establish an effective medical support method through a comparative study of changes in patient trends. A total of 65 patients who visited the Center from April 2017 to March 2018 were examined and their statistics were compared with those of 60 previously reported patients who initially visited the Center for medical examination in 2012. In 2012, many visits occurred during the nursing period; however, in 2017, the number of patients who visited after the weaning period increased. Other noted trends were increased diversity in primary disease, more patient referrals, fewer patients with severe swallowing dysfunction, and more patients with oral dysfunction. The necessity of eating and swallowing practice is thought to increase when lifestyle and oral environment change. The treatment of eating and swallowing disorders is important in the dental profession. Due to the introduction of insurance coverage in Japan in 2018 for developmental insufficiency of oral function, more pediatric patients with eating and swallowing disorders will likely be treated in the future.

Funder: school of tropical medicine and global health, nagasaki university, BACKGROUND: Since the COVID-19 pandemic began, there have been concerns related to the preparedness of healthcare workers (HCWs). This study aimed to describe the level of awareness and preparedness of hospital HCWs at the time of the first wave. METHODS: This multinational, multicenter, cross-sectional survey was conducted among hospital HCWs from February to May 2020. We used a hierarchical logistic regression multivariate analysis to adjust the influence of variables based on awareness and preparedness. We then used association rule mining to identify relationships between HCW confidence in handling suspected COVID-19 patients and prior COVID-19 case-management training. RESULTS: We surveyed 24,653 HCWs from 371 hospitals across 57 countries and received 17,302 responses from 70.2% HCWs overall. The median COVID-19 preparedness score was 11.0 (interquartile range [IQR] = 6.0-14.0) and the median awareness score was 29.6 (IQR = 26.6-32.6). HCWs at COVID-19 designated facilities with previous outbreak experience, or HCWs who were trained for dealing with the SARS-CoV-2 outbreak, had significantly higher levels of preparedness and awareness (p

Most studies report a positive relationship of work engagement with health and job performance, but, occasionally, a "dark side of engagement" has also been uncovered. The current study examined two hypotheses: whether work engagement has (1) a U-shaped curvilinear relation with psychological distress and (2) an inverted U-shaped curvilinear relation with job performance (i.e., in-role performance and creative behavior). A two-wave longitudinal Internet survey with a time lag of seven months was conducted among 1,967 Japanese employees. To test our hypotheses, we used a two-wave panel design and examined the lagged and concurrent relations between work engagement and both outcomes. The results confirmed that work engagement had a curvilinear relation with psychological distress concurrently; a favorable effect was found initially, but this disappeared at intermediate levels of work engagement, and, at higher levels, an adverse effect became prominent. In addition, work engagement had a curvilinear relation with in-role performance both concurrently and longitudinally; the higher the levels of work engagement, the stronger the favorable effects on in-role performance. However, contrary to our expectations, work engagement had a linear relation with psychological distress longitudinally and with creative behavior both concurrently and longitudinally. Hence, our results suggest that work engagement plays a different role in health enhancement compared to performance enhancement. Leveling-off and adverse effects of high work engagement were observed for psychological distress in the short and not in a long run. In contrast, no leveling-off effect of high work engagement was observed for job performance. Thus, except for the short-term effect on psychological distress, no dark side of work engagement was observed for psychological distress and job performance. ispartof: PLOS ONE vol:13 issue:12 ispartof: location:United States status: published

Background and aims The Baveno VI criteria enable non-invasive screening for esophageal varices. However, these criteria were established based on studies examining a large proportion of patients with viral hepatitis and relatively few patients with non-alcoholic fatty liver disease (NAFLD). Furthermore, because vibration-controlled transient elastography (VCTE) has a high incidence of measurement error, improved criteria are needed. We aimed to develop criteria based on magnetic resonance elastography (MRE) even among patients with NAFLD. Methods We performed a cross-sectional analysis of patients who had undergone MRE and/or VCTE as well as an esophagogastroduodenoscopy. The patients were classified as having either a low risk or a high risk of varices. The optimal cut-offs for ruling out esophageal varices were calculated for the MRE and VCTE liver stiffness measurement (LSM), the platelet count in an estimation cohort, and the cut-offs were then evaluated using validation cohorts composed of patients who had undergone only MRE or VCTE. Results The study included 627 patients (39% with NAFLD). The optimal cut-off values for the MRE-LSM and the platelet count were 4.2 kPa and 18.0 × 104 /μL, respectively. An MRE-LSM of 4.2 kPa plus a platelet count of 18.0 × 104 /μL had a negative predictive value of 1.00 for both low-risk plus high-risk varices as well as for high-risk varices in a validation cohort, enabling the presence of varices to be ruled out. Conclusions Magnetic resonance elastography might enable a safer avoidance of screening endoscopy, with a smaller measurement error, among patient populations with a high prevalence of NAFLD.