BACKGROUND: The demand for aged-care services in Japan has surged due to the country's aging population. Furthermore, nationwide survey on the current state of aged-care services revealed that the primary reason for the resignation of women working in these sectors was poor interpersonal relationships. Moreover, given that women working in aged-care services work in shifts around the clock to manage the health and safety of the people in their care, they are at high risk of health-related issues including insomnia symptoms. Thus, we aim to examine the association between levels of satisfaction with interpersonal relationships (LSIR) and insomnia symptoms for women working in aged-care services in Japan, as well as the effect of work-life imbalance on the association between LSIR and insomnia symptoms. METHODS: In this cross-sectional study, the participants were 472 women aged 18-60 years who worked in aged-care services in Japan in 2014-2016. Insomnia symptoms were measured using the Athens Insomnia Scale, and scores of 6 or greater indicated the presence of insomnia. LSIR were assessed through self-administered questionnaires and evaluated at three levels. The association between LSIR and insomnia symptoms was evaluated using a multinominal logistic regression model. Path analysis was used to examine the potential effects of LSIR on insomnia symptoms by incorporating covariates such as work-family conflict, marital status, and depressive symptoms. RESULTS: Compared to high LSIR, the multivariable-adjusted odds ratios (95% confidence interval) of insomnia symptoms were respectively 1.36 (0.81-2.30) and 2.42 (1.11-5.23) for medium and low LSIR. The path analysis showed that low LSIR were significantly associated with having high work-to-family (W-to-F) conflict and being single. CONCLUSIONS Low LSIR were significantly associated with insomnia symptoms among women working in aged-care services in Japan. High W-to-F conflict exacerbated this relationship. Therefore, enhancing interpersonal relationships may be necessary for preventing insomnia. However, due to the cross-sectional nature of our study, causality cannot be inferred. Further longitudinal research is needed to better understand these associations.
Humans ; Japan/epidemiology* ; Sleep Initiation and Maintenance Disorders/psychology* ; Female ; Middle Aged ; Adult ; Cross-Sectional Studies ; Interpersonal Relations ; Young Adult ; Adolescent ; Personal Satisfaction ; Health Services for the Aged/statistics & numerical data*

Abdominal aortic aneurysm and cystic kidneys are both common diseases that have been increasingly detected due to the development of medical screening instruments, such as computed tomography and ultrasonography. We occasionally intraoperatively encounter abdominal aortic aneurysms accompanying cystic renal lesions. However, there have been extremely few reports about abdominal aortic aneurysms complicated by cystic renal disease. Large renal cysts or polycystic kidneys are at risk of rupture or intraoperative hemorrhage, and can hinder the surgical treatment of abdominal aortic aneurysm. Therefore, there is a significant need for surgeons to be able to preoperatively determine the potential of an interruption of the procedure, for example, due to a cystic lesion. In this paper, we report a case of a 77-year-old man with abdominal aortic aneurysm who complained of abdominal fullness due to the presence of large cystic lesions in both kidneys. Preoperatively we aspirated 1, 550ml percutaneously from bilateral renal cysts under ultrasonographic guidance, but did not instill sclerosing agents, such as ethanol. Three days after the percutaneous aspiration, surgical treatment of the abdominal aortic aneurysm (5.2cm in diameter), the left common iliac arterial aneurysm and the right common iliac arterial aneurysm (3.0 and 2.6cm in diameter) was performed through a median abdominal incision with a retroperitoneal approach. The arterial prosthesis used was a Y-shaped woven double velour vascular graft. The postoperative course was uneventful and the patient was discharged 14 days after the vascular reconstruction procedure. Our experience suggests that percutaneous aspiration of large renal cysts that might hinder the surgical procedure for abdominal aortic aneurysm is useful.

The relationship between the drug effect and the time interval from operation or onset of hepatitis or hepatic damage to the beginning of the administration of Chinese herb medicines allowed us to postulate the usual clinical course of the disease as follows from the viewpoint of traditional Chinese medicine: namely two months after surgery or onset of the disease being the Yang stage, the four months after the Yang stage being the Yang-Yin transitional stage and after this being the Yin stage. The Yin stage was further divided into earlier and later periods, the border line being five years after the operation or onset of the disease.
In the Yang stage the drug effect was mostly excellent, and the medicines used were mainly for Qi-fen and Re-zheng, as well as the medicines used in the Yang-Yin transitional stage when healing of the excellent cases and increase of the cases with good effect were characteristic. In the earlier Yin stage the cases with no effect began to increase, and the medicines used ranged from Qi-fen to Ying-fen . In the later Yin stage the cases with excellent effect disappeared, and the cases with good or no effect were dominant. In this stage the medicines for Xue-fen were sometimes added to the medicines for Qi-fen or Ying-fen, and relative increase of the medicines for Xu-han-zheng was noticed.