Measuring the symptomatic, physical, emotional and social impacts of dry mouth: A qualitative study

Objective To explore the impacts of dry mouth in order to develop a comprehensive condition‐specific OHRQoL measure. Background Dry mouth has been shown to have significant, if not more severe impacts on OHRQoL, than dental caries. Yet there remain few studies reporting on how to develop a comprehensive measure of the impact of dry mouth on OHRQoL. Methods This study was a qualitative study using semi‐structured interviews. Data were collected from a purposive sample of 17 people with dry mouth (14 women, three men). The sample was drawn to capture a comprehensive range of impacts of dry mouth. These interviews were analysed using a framework approach informed by existing functionalist approaches to OHRQoL. Results Participants reported a huge range of symptoms associated with perceived dry mouth resulting in extensive impacts on physical, emotional (psychological) and social functioning. Dry mouth could also result in restrictions in social participation which, under some conditions, could be disabling. These impacts were modified by psychological, social and environmental factors. Conclusions If we are to measure the impacts of oral conditions, it is important that this is done systematically and with reference to existing conceptual models of health. Current measures of the impact of dry mouth cover symptoms, discomfort and physical impacts along with some aspects of how people cope with the condition. This study proposes a more comprehensive approach that includes the full range of impacts people experience. Such an approach may enable us to focus on “downstream” and “upstream” interventions for dry mouth

診断用放射線被曝線量測定の意義

診断用X線装置と撮影法については最近, 目覚しい技術的発展が見られる。技術的発展がどのように被曝線量の低減化に寄与しているか検証するために, 広島と長崎の1991年以前の診療用放射線被曝線量推定値を最近報告されている推定値と比較した。比較は主にCT検査と一般撮影について行った。最近の全国的な調査・研究で報告された被曝線量平均値は類似の検査における1991年以前の広島・長崎における推定値とほぼ同じであった。そのことは, 最近の技術的発展が被曝線量の低減化の実現に結びついていないことを示唆していると思われる。全ての施設で診療用被曝線量を最新の技術で可能な必要最小限な量にまで下げるには, 診療用放射線の危険性について広く理解されること, そして診療放射線技師による定期的な被曝線量測定と公表が多くの施設で行われることが必要である。Recently, several significant technical developments have been made in diagnostic x-ray equipment and radiography. In order to examine how technical developments have contributed to the reduction of radiation doses received by patients, estimated diagnostic x-ray doses for examinations before 1991 were compared with recent estimates. The comparisons were mainly focused on CT examinations and general radiography. X-ray doses shown by recent national surveys are scarcely different from previous x-ray doses. The results of the comparisons suggest that recent technical developments have not reduced the average radiation doses to examinees. It is desirable that the diagnostic x-ray doses in all institutions be reduced to the lowest levels possible using modern techniques. This can be achieved if the risks of diagnostic radiation are widely recognized, and if radiological technicians in a large number of institutions would periodically measure and publish radiation doses from major diagnostic x-ray examinations.総説General Article国立情報学研究所で電子

malERA: An updated research agenda for characterising the reservoir and measuring transmission in malaria elimination and eradication

This paper summarises key advances in defining the infectious reservoir for malaria and the measurement of transmission for research and programmatic use since the Malaria Eradication Research Agenda (malERA) publication in 2011. Rapid and effective progress towards elimination requires an improved understanding of the sources of transmission as well as those at risk of infection. Characterising the transmission reservoir in different settings will enable the most appropriate choice, delivery, and evaluation of interventions. Since 2011, progress has been made in a number of areas. The extent of submicroscopic and asymptomatic infections is better understood, as are the biological parameters governing transmission of sexual stage parasites. Limitations of existing transmission measures have been documented, and proof-of-concept has been established for new innovative serological and molecular methods to better characterise transmission. Finally, there now exists a concerted effort towards the use of ensemble datasets across the spectrum of metrics, from passive and active sources, to develop more accurate risk maps of transmission. These can be used to better target interventions and effectively monitor progress toward elimination. The success of interventions depends not only on the level of endemicity but also on how rapidly or recently an area has undergone changes in transmission. Improved understanding of the biology of mosquito-human and human-mosquito transmission is needed particularly in low-endemic settings, where heterogeneity of infection is pronounced and local vector ecology is variable. New and improved measures of transmission need to be operationally feasible for the malaria programmes. Outputs from these research priorities should allow the development of a set of approaches (applicable to both research and control programmes) that address the unique challenges of measuring and monitoring transmission in near-elimination settings and defining the absence of transmission

Coital frequency and condom use in monogamous and concurrent sexual relationships in Cape Town, South Africa

Introduction: A decreased frequency of unprotected sex during episodes of concurrent relationships may dramatically reduce the role of concurrency in accelerating the spread of HIV. Such a decrease could be the result of coital dilution - the reduction in per-partner coital frequency from additional partners - and/or increased condom use during concurrency. To study the effect of concurrency on the frequency of unprotected sex, we examined sexual behaviour data from three communities with high HIV prevalence around Cape Town, South Africa. Methods: We conducted a cross-sectional survey from June 2011 to February 2012 using audio computer-assisted self-interviewing to reconstruct one-year sexual histories, with a focus on coital frequency and condom use. Participants were randomly sampled from a previous TB and HIV prevalence survey. Mixed effects logistic and Poisson regression models were fitted to data from 527 sexually active adults reporting on 1210 relationship episodes to evaluate the effect of concurrency status on consistent condom use and coital frequency. Results: The median of the per-partner weekly average coital frequency was 2 (IQR: 1 - 3), and consistent condom use was reported for 36% of the relationship episodes. Neither per-partner coital frequency nor consistent condom use changed significantly during episodes of concurrency (aIRR = 1.05; 95% confidence interval (CI): 0.99-1.24 and aOR = 1.01; 95% CI: 0.38-2.68, respectively). Being male, coloured, having a tertiary education, and having a relationship between 2 weeks and 9 months were associated with higher coital frequencies. Being coloured, and having a relationship lasting for more than 9 months, was associated with inconsistent condom use. Conclusions: We found no evidence for coital dilution or for increased condom use during concurrent relationship episodes in three communities around Cape Town with high HIV prevalence. Given the low levels of self- reported consistent condom use, our findings suggest that if the frequency of unprotected sex with each of the sexual partners is sustained during concurrent relationships, HIV-positive individuals with concurrent partners may disproportionately contribute to onward HIV transmission