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Thanks for opportunity review revised manuscript entitled ‘‘Cross-sectional associations between effort-reward imbalance at work and oral diseases in Japan’’. I would like the thanks to authors. They make a good job for improving quality of their manuscript. Authors revised the manuscript as I requested with a good will. In this form, Introduction reflects very well the previous studies and study aim, Method section and Result section is correct, and Discussion section adequately synthesis to previous study findings and current study results. Overall, I have no further comment regarding to manuscript. I congratulate to authors and wish them success on their future endeavors.
Dear author,
Thank you for your effort in conducting the study and submitted the manuscript for possible publication in PeerJ. Please revise the manuscript as per suggestions from the reviewers and resubmit as soon as possible. Thank you
[# PeerJ Staff Note: Please ensure that all review and editorial comments are addressed in a response letter and any edits or clarifications mentioned in the letter are also inserted into the revised manuscript where appropriate. #]
Minor problems exist in this section.
Significant improvement required in this section.
I think, the findings are valid.
Thanks for opportunity to review manuscript entitled ‘‘Cross-sectional associations between effort-reward imbalance at work and oral diseases in Japan’’ for Peerj Journal. The author/authors examined the association between effort-reward imbalance at work and oral diseases among Japon workers. The strength of the manuscript includes examining variables of interest in a country where such studies are scarce. Overall, although the article is generally well written and deserves to be published in this journal some necessary and minor revisions must be made before the publication of the article. Because my main philosophy of reviewing a manuscript as reviewer and sometimes an editor to improve the manuscript and not punishing the authors, I provided very specific and detailed peer review of the manuscript to increase its quality and citation potential. I hope authors of the manuscript may benefit from my review. Necessary revisions reported section by section with the page and line number and when possible with suggestions.
Necessary Revisions
Abstract
1. Abstract, Line 15-16: Author need to revise following sentence ‘ ‘ However, evidence for association between work stress and oral diseases is lacking.’’ One revision may be ‘ ‘However, evidence for association between work stress and oral diseases is scarce.’’
2. Abstract, Line 19-23: Author must add used statistical analyses to Method section.
3. Abstract, Line 31: Discussion: must revised as Conclusion:
4. Abstract, General: Keywords are completely missing and must be added.
Introduction
5. Introduction, Line 36: There is a typo in the sentence. high eorts must be high efforts.
6. Introduction, Line 37-39: Following sentence need revision as when model predict these outcomes is unclear. ‘ ‘The model predicts increased risks for depression (Rugulies, Aust & Madsen, 2017), hypertension (Gilbert-Ouimet et al., 2014), coronary heart disease (Li et al., 2015), and type 2 diabetes (Kumari, Head & Marmot, 2004)’’ One revision may be that ‘ ‘The model predicts increased risks for depression (Rugulies, Aust & Madsen, 2017), hypertension (Gilbert-Ouimet et al., 2014), coronary heart disease (Li et al., 2015), and type 2 diabetes (Kumari, Head & Marmot, 2004) when effort-reward imbalance high.’’
7. The citation/citations needed for following sentence ‘ ‘Notably, most previous studies did not use the widely accepted measures for work stress assessment and did not include potential confounders, such as socioeconomic status and work-related variables’’
8. Introduction, General: Introduction section is very weak for a scientific article. Authors must firstly add information about previous studies, weakness of previous studies and what their study add to existing literature. Moreover, Authors need to answer Why it is important to examine effort-reward imbalance at work and oral diseases among Japon workers? With convincing information.
9. Introduction, General: Author must move following paragraph to end of Introduction and synthesize with psychological stress paragraph. It illogical to first give information about independent then dependent variable. ‘ ‘ Work stress has become more prevalent at the workplaces of industrialised countries and can negatively impact workers' health (Siegrist, 2016). The effort–reward imbalance model is a widely accepted model for assessment of work stress (Siegrist, 1996; Montano, Li & Siegrist,2016). It focuses on the failure in reciprocity in terms of high eorts spent and low rewards received. The model predicts increased risks for depression (Rugulies, Aust & Madsen, 2017), hypertension (Gilbert-Ouimet et al., 2014), coronary heart disease (Li et al., 2015), and type 2 diabetes (Kumari, Head & Marmot, 2004).
Method
10. Method, Line 71-91: Author must add mean and standard deviation of samples to Participants section. Moreover, author must add used sampling procedure (convenience sampling).
11. Method, Line 96: ranging between 3 and 13 must be ranging between 3 and 12
12. Method, Line 99: There is a typo in the sentence. high eorts must be high efforts.
13. Method, Line 155: In two-tailed significance, p must be small.
14. Method, General: Method section must rearrange using subtitles, Participants, Measures, Procedure, and Statistical Analyses and authors move all related information to related sections.
15. Method, General: Author must give more information about established procedure for effort reward-imbalance. As I am unfamiliar this, it is difficult to understand.
Results
16. Results, General: All small n must be italic in Table 1 representing subsample or sample sizes.
17. Results, General: Authors must add Notes section under the Table 2 and report significance levels of significant findings.
18. Results, General: Authors must add Notes section under the Table 3 and report significance levels of significant findings.
19. Results, General: As a multivariate analyst, I think authors must add r square values for adjusted linear regression model and interpret effect size of this measures. Similarly, Int the table 1 mean difference statement is completely wrong for linear and negative binominal regression analyses. Expected mean difference may be correct. However, for negative binominal regression analyses, this have to be expected log odds of what ever measured. I think authors want to mean unstandardized regression coefficients for linear regression, and incidence rate ration for negative binominal regression analyses.
19. Results, General: Authors must add following information to tables. For linear regression analyses, unstandardized regression coefficients and standard errors with p values with three decimal, Moreover, r square value for final model. For negative binominal regression analyses and Poisson regression, IRR with its standard error and p value three decimal as well as pseuodo r square values.
20. Results, General: the reason for using negative binominal regression analyses and preference for posison regression unclear. Authors must give convincing information about using them. For example, overdispersion also may be modeled zero-inflated negative binomial regression similarly, zero-inflated poisson regression also may be used to accommodate excessive zeros in teeth numbers.
Discussion
21. Discussion, General: Following information must remove before conclusion section ‘ ‘This study has two strengths. First, work stress was assessed using a widely accepted measure. Previous studies on work stress and oral diseases have often used nonspecific
questionnaires (Sato, Saijo & Yoshioka, 2021). This study captured work stress more accurately than previous studies. Second, this study included potential confounders, such as socioeconomic status and work-related variables. Our review revealed only two studies among the 11 studies included in the systematic review considered the potential confounders sufficiently (Sato, Saijo& Yoshioka, 2021). Our study is superior to previous studies in terms of these two points. However, our study had three limitations. First, periodontal status was assessed using a self- reported questionnaire which potentially has self-reported bias (Yamamoto et al., 2009; Beltrán-Aguilar et al., 2012). This questionnaire was not validated among young or female workers (Yamamoto et al., 2009). Furthermore, the cut-off point of this questionnaire was defined based on 7 mm or more of the clinical attachment loss, which differs from the 2018 periodontitis case definition by the European Federation of Periodontology and American Association of
Periodontology with Centers for Disease Control (Botelho et al., 2020). This limitation can
produce a bias. In addition, the participants with work stress may have had exaggerated
responses to questions on periodontitis screening. When interpreting the periodontal status
results, these limitations should be considered. In the second source population survey, DMFT was estimated using intraoral photographs with mobile phones. Molars had a relatively higher percentage of undiagnosable status than incisors and premolars, and some DT and FT were
missed. Therefore, DMFT could have been underestimated in the second source population. This unvalidated method can bring about a bias. However, the results in the second source population were consistent with those in the first source population, for which DMFT was assessed on the clinical examination. Second, in the two-source population, many participants had a high socioeconomic status. More than 70% of participants had university degrees or higher. The social gradients of oral diseases have been reported (Borrell & Crawford, 2012; Schwendicke etal., 2015). Additionally, blue-collar workers were also small in number. Participants in the two-source population had better oral conditions than those in the national survey (Ministry of Health, Labour and Welfare, 2016). The results of people with low socioeconomic status and blue-collar workers might have been underestimated in this study. Finally, this study was cross-sectional; therefore, a temporal association was not established. Further cohort studies are required.
22. Discussion, General: Clinical and practical implications of study findings are completely missing in the manuscript and must be added.
This is a carefully conducted study on a topic of scientific interest as few investigations are available, internationally, on this topic. Authors have presented the current state of art in convincing ways, adding their own systematic review (published 2021). The Introduction is well written, and the quality of study design, data analysis and interpretation meets the standard for publication in an international journal. Authors also critically address the limitations of their study, thus contributing to a process of knowledge acquisition. The main finding of a significant association of work stress, as measured by a theoretically grounded concept, with poor periodontal status is of practical relevance.
The study design deserves some comments. On the positive side, the procedure of data collection is clearly described. The statistical analyses reflect the current state of arts, and authors document their expertise e.g. by adopting most advanced statistical programs. The information presented in Tables is accurate, and a special strength is given by the inclusion of a substantial number of covariates into multivariable analysis.
On the negative side, one wonders what the effect of sample loss (e.g. from 527 to 184 participants in study 1) on the study results might be. If I understand correctly, work stress data were available from the larger sample (e.g. 527 in study 1) as well. In this case, authors could have checked whether the final sample differs in terms of the independent variable from the original sample. At least, in the Discussion section, authors should address the problem of sample loss.
No further comment.
Keeping the above mentioned critical comment (potential reduction of validity due to sample loss with uncontrolled bias) in mind, the validity of the reported findings is credible. Authors pointed to the methodological limitations of their study (especially cross-sectional design; underestimation of DMFT). As mentioned, the innovative message of this study should be considered a particular strength.
No additional comment
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