Questionnaire survey on the continuity of home oxygen therapy after a disaster with power outages

AbstractBackgroundAfter the Great East Japan Earthquake, oxygen-dependent patients in areas experiencing power outages could not continue home oxygen therapy (HOT) without oxygen cylinders. The purpose of this study was to examine use of oxygen cylinders in areas experiencing power outages and the effects of HOT interruption on patients' health.MethodsQuestionnaires were mailed to 1106 oxygen-dependent patients and HOT-prescribing physicians in Akita, near the disaster-stricken area. We investigated patients' actions when unable to use an oxygen concentrator and classified the patients based on oxygen cylinder use. Patients who experienced an interruption of or reduction in oxygen flow rate by their own judgment were assigned to the “interruption” and “reduction” groups, respectively; those who maintained their usual flow rate were assigned to the “continuation” group. Differences were tested using analysis of variance and the χ2 tests.ResultsIn total, 599 patients responded to the questionnaire. Oxygen cylinders were supplied to 574 patients (95.8%) before their oxygen cylinders were depleted. Comparison of the continuation (n=356), reduction (n=64), and interruption (n=154) groups showed significant differences in family structure (p=0.004), underlying disease (p=0.014), oxygen flow rate (p<0.001), situation regarding use (p<0.001), knowledge of HOT (p<0.001), and anxiety about oxygen supply (p<0.001). There were no differences in changes in physical condition.ConclusionsMost patients could receive oxygen cylinders after the disaster. Some patients discontinued their usual oxygen therapy, but their overall health status was not affected

Placebo effect and dental treatment

舌痛症や口腔異常感症など口腔内に器質的異常所見を認めないにも関わらず，痛み，違和感など生じる症状をMedically Unexplained Oral Symptoms (MUOS) と呼ぶ。当科では年間500～600人のMUOSに苦しむ患者が受診しており，多くの患者がMUOSに苦しんでいることがわかる。MUOSを訴える患者の多くが歯科治療を経験しており，歯科治療に対する不平，不満を訴えることが多い。患者にとって歯科治療が自身の期待していたものと異なっていたことがMUOSを生じさせる一つの要因であると推測される。 プラセボ（偽薬）は，薬理作用が期待できないにも関わらず症状を改善させることが知られている。最近プラセボ効果を説明する概念としてBayesian brainというものが提唱されている。 本総説ではMUOSおよび近年のプラセボ研究を紹介し，MUOSを生じさせない歯科治療のあり方について考察する

Validation of self-reported articulatory oral motor skill against objectively measured repetitive articulatory rate in community-dwelling older Japanese adults : The Otassha Study

Aim: To assess the validity of self-reported articulatory oral motor skill against objectively measured repetitive articulatory rate (oral diadochokinesis [oral-DDK]) as a gold standard index for articulatory oral motor skill in community-dwelling older Japanese adults.　Methods: This cross-sectional study included 607 Japanese adults (mean age = 73.9 years). A single-item self-report questionnaire for articulatory oral motor skill was developed. Study participants completed a 1-month-interval test-retest protocol to assess reliability of the questionnaire, and the protocol was tested by the kappa statistic. Oral-DDK with /ta/ (i.e., the number of repetitions of the monosyllable /ta/ per second) was measured during the on-site examination. Low oral-DDK performance was defined as <5.2 times/s in men and <5.4 times/s in women. Oral-DDK performance, oral functions other than articulatory oral motor skill, and physical frailty were compared in the groups with and without self-reported low articulatory oral motor skill as determined by the response to the questionnaire.　Results: Self-reported low articulatory oral motor skill was identified in 18.5% of the study population. The self-report questionnaire had good test-retest reliability, with a kappa statistic of 0.71. Self-reported low articulatory oral motor skill was significantly associated with a lower value of oral-DDK with /ta/ and a higher proportion of low oral-DDK performance, difficulties in chewing and swallowing, dry mouth, and physical frailty. Self-report had high specificity (83.1%) but low sensitivity (42.1%) for detecting low oral-DDK performance.　Conclusions: A single-item self-report questionnaire for articulatory oral motor skill had acceptable test-retest reliability and was associated with objectively measured articulatory oral motor skill